Individual
BIANCA MAILLOUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4201 KENT RD, ROYAL OAK, MI 48073-0002
(317) 993-9057
Mailing address
4201 KENT RD, ROYAL OAK, MI 48073-0002
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
4704358882
MI
Other
Enumeration date
05/18/2023
Last updated
05/18/2023
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