Individual
ALICIA PENNYMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPRM
Contact information
Practice address
1121 E MCNICHOLS RD, DETROIT, MI 48203-2857
(313) 365-3141
(313) 365-3101
Mailing address
1121 E MCNICHOLS RD, DETROIT, MI 48203-2857
(313) 365-3141
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/17/2019
Last updated
07/19/2019
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