Individual
JABARI MOYENDA OSAZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
707 MILWAUKEE AVE, DETROIT, MI 48202
(313) 989-9444
Mailing address
707 MILWAUKEE AVE, DETROIT, MI 48202
(313) 989-9444
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
4704149257
MI
Other
Enumeration date
10/21/2024
Last updated
10/21/2024
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