Organization
HEALTH AND WELLNESS OF MI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAKAUWRA SANDOVAL (CEO)
(702) 683-9050
Entity
Organization
Contact information
Practice address
220 W CONGRESS ST # 513, DETROIT, MI 48226-3289
(702) 683-9050
Mailing address
220 W CONGRESS ST # 513, DETROIT, MI 48226-3289
Taxonomy
Speciality
Code
Description
License number
State
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
—
—
2084P0800X
Psychiatry Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/04/2026
Last updated
05/04/2026
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