Individual
KHADIJA SHABAZZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20300 SUPERIOR RD STE 250, TAYLOR, MI 48180-6342
(734) 785-7700
Mailing address
4334 ROSA PARKS BLVD, DETROIT, MI 48208-2704
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
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