Individual
MISS TICILA IRBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28303 JOY RD, WESTLAND, MI 48185-5524
(734) 450-5910
Mailing address
28303 JOY RD, WESTLAND, MI 48185-5524
(734) 450-5910
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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