Individual
CHANTIA DALLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
37450 SCHOOLCRAFT RD STE 110, LIVONIA, MI 48150-1000
(734) 458-4601
Mailing address
30931 FERNWOOD ST, WESTLAND, MI 48186-5097
(734) 765-7709
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
12/10/2024
Last updated
12/10/2024
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