Individual
MIA HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18926 FORRER ST, DETROIT, MI 48235-2913
(803) 626-6504
Mailing address
18926 FORRER ST, DETROIT, MI 48235-2913
(803) 626-6504
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
07/04/2018
Last updated
07/04/2018
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