Individual
ANGELICA DETOMASO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 STODDARD RD, RICHMOND, MI 48062-2505
(810) 392-2137
Mailing address
25156 HAYES RD, ROSEVILLE, MI 48066-3646
(586) 222-7481
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/27/2021
Last updated
08/27/2021
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