Individual
DAJUANA WITCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19719 FAUST AVE, DETROIT, MI 48219-2116
(248) 904-3608
Mailing address
19719 FAUST AVE, DETROIT, MI 48219-2116
(248) 904-3608
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703122690
MI
Other
Enumeration date
09/07/2023
Last updated
09/07/2023
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