Individual
BIANACA K BLALOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12800 E WARREN AVE, DETROIT, MI 48215-2061
(313) 308-1400
Mailing address
12800 E WARREN AVE, DETROIT, MI 48215-2061
(313) 308-1400
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
MI
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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