Individual
QUIANNA STREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15900 W 10 MILE RD STE 211444, SOUTHFIELD, MI 48075-2036
(310) 696-9555
Mailing address
8450 CEDARWOOD LN, RANCHO CUCAMONGA, CA 91730-3251
(310) 696-9555
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
Primary
—
CA
342000000X
Transportation Network Company
—
—
Other
Enumeration date
08/29/2023
Last updated
06/27/2024
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