Individual
MADELINE LIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
42 N MOUNT TOM RD, MIO, MI 48647-8739
(989) 826-3208
Mailing address
42 N MOUNT TOM RD, MIO, MI 48647-8739
(989) 826-3208
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
171M0000X
—
Other
Enumeration date
03/21/2023
Last updated
03/21/2023
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