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Individual

KELLY DANEIL-MARIE JEFFERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BS

Contact information

Practice address
12800 E WARREN AVE, DETROIT, MI 48215-2061
(877) 242-4140
Mailing address
16300 W 9 MILE RD APT 217, SOUTHFIELD, MI 48075-5909
(313) 208-1963

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
MI

Other

Enumeration date
09/11/2025
Last updated
10/24/2025
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