Individual
MRS. LESLIE RUTLAND-TIPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.DIV., BCC
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1776
Mailing address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1776
Taxonomy
Speciality
Code
Description
License number
State
374K00000X
Religious Nonmedical Practitioner
Primary
NA
MI
Other
Enumeration date
11/17/2023
Last updated
11/17/2023
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