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Individual

SHIRLEY DIAMOND-HOLTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
101 E JOLLY RD APT B8, LANSING, MI 48910-6683
(517) 410-6252
Mailing address
101 E JOLLY RD APT B8, LANSING, MI 48910-6683
(517) 410-6252

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
98432963
STATE OF MICHIGAN
MI
01
SS 9198
SS LAST 4-9198
MI
Enumeration date
09/30/2016
Last updated
09/30/2016
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