Individual
BIANCA WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35425 W MICHIGAN AVE, WAYNE, MI 48184-9800
(734) 467-7600
Mailing address
35425 W MICHIGAN AVE, WAYNE, MI 48184-9800
(734) 467-7600
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6801093562
MI
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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