Individual
MISS KOURTNI MONCREASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19401 NORTHLINE RD, SOUTHGATE, MI 48195-2277
(313) 329-9259
Mailing address
19401 NORTHLINE RD, SOUTHGATE, MI 48195-2277
(313) 329-9259
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/26/2016
Last updated
07/28/2016
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