Individual
JACQUELINE MONZELL WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19321 GREENFIELD RD, DETROIT, MI 48235-2004
(313) 586-2618
Mailing address
383 KEELSON DR, DETROIT, MI 48215-3077
(313) 971-6025
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
727960
—
MI
Enumeration date
06/30/2017
Last updated
07/08/2017
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