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Individual

TENESSA HOUSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5790 BERKSHIRE ST, DETROIT, MI 48224-3208
(313) 587-7039
Mailing address
5790 BERKSHIRE ST, DETROIT, MI 48224-3208
(313) 587-7039

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
845080656
MI
05
9510367
MI
Enumeration date
07/01/2021
Last updated
07/01/2021
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