Individual
TAIRAN DALE MALACHI- COONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3111 ELECTRIC AVE, PORT HURON, MI 48060-8127
(810) 985-8900
Mailing address
2831 W VILLAGE LN, PORT HURON, MI 48060-1895
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/12/2019
Last updated
05/12/2019
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