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Individual

ALYSSE WADE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
13101 ALLEN RD BLDG 2, SOUTHGATE, MI 48195-2216
(734) 625-3695
Mailing address
167 S GROVE ST APT 108, YPSILANTI, MI 48198-5665

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
09/12/2023
Last updated
09/12/2023
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