Individual
MRS. KYESHA NICOLE WORTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
14218 BRAILE ST, DETROIT, MI 48223-2720
(313) 404-8244
Mailing address
14218 BRAILE ST, DETROIT, MI 48223-2720
(313) 404-8244
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
230012659100806
MI
Other
Enumeration date
03/03/2021
Last updated
03/03/2021
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