Individual
TANISHA LANAI CRUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24576 ORANGELAWN, 24576 ORANGELAWN, REDFORD, MI 48239
(313) 828-7756
Mailing address
24576 ORANGELAWN, 24576 ORANGELAWN, REDFORD, MI 48239
(313) 828-7756
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
C651785488138
—
MI
Enumeration date
12/15/2021
Last updated
12/15/2021
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