Individual
MECHELLA L DERRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19251 MACK AVE, GROSSE POINTE WOODS, MI 48236-2893
(586) 701-1622
Mailing address
19251 MACK AVE, GROSSE POINTE WOODS, MI 48236-2893
(586) 701-1622
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
09/21/2021
Last updated
09/21/2021
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