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Individual

KEISHA SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
20312 ROSEDALE ST, SAINT CLAIR SHORES, MI 48080-4227
(313) 790-5370
Mailing address
20312 ROSEDALE ST, SAINT CLAIR SHORES, MI 48080-4227
(313) 790-5370

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
251E00000X
Home Health Agency
Primary
MI

Other

Enumeration date
06/08/2016
Last updated
04/15/2019
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