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Individual

ELAINE DIANE CHURCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
10405 VERNON AVE, HUNTINGTON WOODS, MI 48070-1526
(248) 752-5122
Mailing address
10405 VERNON AVE, HUNTINGTON WOODS, MI 48070-1526

Taxonomy

Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary

Other

Enumeration date
12/14/2023
Last updated
12/14/2023
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