Individual
DONNA TACTAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
16200 19 MILE RD, CLINTON TWP, MI 48038-1103
(586) 263-8696
(586) 263-8731
Mailing address
14570 ISLAND DR, STERLING HEIGHTS, MI 48313-2212
(586) 566-6048
(586) 263-8696
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
4704188742
MI
Other
Enumeration date
05/16/2007
Last updated
07/08/2007
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