Individual
MARY PAULINE LIDDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2766 W 11 MILE RD STE 2, BERKLEY, MI 48072-3033
(248) 542-2424
(248) 542-5621
Mailing address
2766 W 11 MILE RD STE 2, BERKLEY, MI 48072-3033
(248) 542-2424
(248) 542-5621
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
4704211913
MI
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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