Individual
KADIATOU DIALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17126 WASHBURN ST, DETROIT, MI 48221-2439
(614) 446-5341
Mailing address
17126 WASHBURN ST, DETROIT, MI 48221-2439
(614) 446-5341
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05
—
MI
Enumeration date
03/09/2021
Last updated
03/09/2021
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