Individual
CONNIE HUBBARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9912 LEVERNE, REDFORD, MI 48239-2241
(313) 693-5486
Mailing address
9912 LEVERNE, REDFORD, MI 48239-2241
(313) 693-5486
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/28/2017
Last updated
03/28/2017
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