Individual
DOLORES MATTOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
24424 W MCNICHOLS RD, DETROIT, MI 48219-3653
(313) 531-2500
Mailing address
24080 SENECA ST, OAK PARK, MI 48237-3725
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
4704125356
MI
Other
Enumeration date
08/09/2007
Last updated
08/09/2007
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