Individual
WANDA MITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24424 W MCNICHOLS RD, DETROIT, MI 48219-3653
(313) 531-2500
Mailing address
24424 W MCNICHOLS RD, DETROIT, MI 48219-3653
(313) 531-2500
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
MI
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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