Individual
TIYE BUNDLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16246 NORMANDY ST, DETROIT, MI 48221-3314
(313) 399-4970
Mailing address
16246 NORMANDY ST, DETROIT, MI 48221-3314
(313) 399-4970
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
09/23/2025
Last updated
09/23/2025
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