Individual
AMY LAUREN KONJA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22170 W 9 MILE RD, SOUTHFIELD, MI 48033-6007
(248) 372-6800
Mailing address
22170 W 9 MILE RD, SOUTHFIELD, MI 48033-6007
(248) 372-6800
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
M626066488534
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171M00000X
CASE MANAGER
MI
05
—
171M00000X
—
MI
Enumeration date
01/23/2023
Last updated
01/23/2023
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