Individual
MS. TAWIANA FILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
150 STIMSON ST, DETROIT, MI 48201-2410
(313) 993-4700
Mailing address
19211 ANGLIN ST, DETROIT, MI 48234-1460
(313) 263-0077
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
381459371
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
381459371
—
MI
Enumeration date
08/18/2016
Last updated
08/18/2016
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