Individual
TIARA NICOLE BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18191 21 MILE RD, MACOMB, MI 48044-2703
(586) 872-5760
Mailing address
18191 21 MILE RD, MACOMB, MI 48044-2703
(586) 872-5760
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8477858
—
MI
Enumeration date
02/19/2019
Last updated
02/19/2019
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