Individual
MRS. JEVITAS LETRICE ANTHONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SOCIAL WORKER
Contact information
Practice address
2051 W GRAND BLVD, DETROIT, MI 48208-1105
(313) 961-3200
Mailing address
2051 W GRAND BLVD, DETROIT, MI 48208-1105
(313) 961-3200
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802079514
MI
Other
Enumeration date
02/10/2009
Last updated
02/10/2009
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