Individual
MS. MARYELLEN BERTHIAUME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
26180 OUTER DR, LINCOLN PARK, MI 48146-2084
(313) 389-7558
(313) 383-7293
Mailing address
26180 OUTER DR, LINCOLN PARK, MI 48146-2084
(313) 389-7558
(313) 383-7293
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
4704237854
MI
Other
Enumeration date
11/06/2017
Last updated
11/06/2017
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