Individual
BLANDINA MARGARET ROSE-WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED, PHD
Contact information
Practice address
1239 BAGLEY ST, DETROIT, MI 48226-1002
(313) 550-4130
Mailing address
1239 BAGLEY ST, DETROIT, MI 48226-1002
(313) 550-4130
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401003078
MI
Other
Enumeration date
11/12/2021
Last updated
11/12/2021
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