Individual
CANDACE LEE WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15601 NORTHLINE RD, SOUTHGATE, MI 48195-2334
(734) 785-7705
Mailing address
15601 NORTHLINE RD, SOUTHGATE, MI 48195-2334
(734) 785-7705
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/27/2011
Last updated
05/27/2011
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