Individual
MYNESHA AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW, LLBSW
Contact information
Practice address
35425 W MICHIGAN AVE STE 1, WAYNE, MI 48184-1600
(734) 722-4686
(734) 467-7646
Mailing address
35425 W MICHIGAN AVE STE 1, WAYNE, MI 48184-1600
(734) 722-4686
(734) 467-7646
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6802090567
MI
Other
Enumeration date
12/04/2019
Last updated
12/04/2019
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