Individual
DEZHA WILLOUGHBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
229 N SHELDON RD, PLYMOUTH, MI 48170-1524
(313) 278-4601
Mailing address
26789 WOODWARD AVE STE 103, HUNTINGTON WOODS, MI 48070-1334
(248) 631-4728
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225700000X
Massage Therapist
Primary
7501014617
MI
Other
Enumeration date
08/16/2019
Last updated
11/10/2021
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