Individual
RENIA SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5211 BERKSHIRE ST, DETROIT, MI 48224
(313) 421-4130
Mailing address
5211 BERKSHIRE ST, DETROIT, MI 48224-3205
(313) 421-4130
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703058673
MI
172V00000X
Community Health Worker
—
MI
3747A0650X
Attendant Care Provider
—
MI
376J00000X
Homemaker
—
MI
Other
Enumeration date
12/06/2019
Last updated
04/03/2020
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