Individual
GENA DO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2700 HAMLIN BLVD, INKSTER, MI 48141-2206
(313) 516-5100
Mailing address
3840 PFEIFFER WOODS CT SE, KENTWOOD, MI 49512-9162
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801109819
MI
Other
Enumeration date
08/30/2018
Last updated
06/21/2021
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