Individual
VANESSA CAROL DENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15717 HEYDEN ST, DETROIT, MI 48223-1240
(313) 728-2091
Mailing address
15717 HEYDEN ST, DETROIT, MI 48223-1240
(313) 728-2091
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
D520839108827
MI
Other
Enumeration date
11/16/2024
Last updated
11/16/2024
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