Individual
DANIELLE MARIE SISSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20461 SPRUCE RD, BIG RAPIDS, MI 49307-9731
(231) 527-1724
Mailing address
20461 SPRUCE RD, BIG RAPIDS, MI 49307-9731
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AF540281079
MI
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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