Individual
MS. CARRIE ELAINE NANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
15000 GRATIOT AVE, DETROIT, MI 48205-1973
(313) 245-0600
Mailing address
15200 SILVER PKWY, #304, FENTON, MI 48430-3481
(810) 275-5863
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
50731
MI
Other
Enumeration date
01/09/2007
Last updated
07/08/2007
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