Individual
TARRA SANTREECE BOOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20101 APPOLINE ST, DETROIT, MI 48235-1120
(248) 565-6697
Mailing address
28475 GREENFIELD RD STE 113, SOUTHFIELD, MI 48076-3034
(248) 565-6697
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
230013951631107
MI
Other
Enumeration date
06/20/2023
Last updated
06/20/2023
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