Individual
KIMBERLY HAGGERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
18463 LIVERNOIS AVE, DETROIT, MI 48221-2254
(313) 861-4400
Mailing address
14671 TELEGRAPH RD, REDFORD, MI 48239-3300
(313) 948-3055
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/25/2021
Last updated
02/11/2025
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