Individual
ELSABETH ENGEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4464 HICKORY DRIVE, OKEMOS, MI 48864
(517) 402-6191
Mailing address
4464 HICKORYWOOD DR, OKEMOS, MI 48864-3076
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
MI
Other
Enumeration date
01/09/2017
Last updated
01/09/2017
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