Individual
MR. ANTHONY DIONN YANISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10 PETERBORO ST, DETROIT, MI 48201-2722
(313) 831-3160
Mailing address
10 PETERBORO ST, DETROIT, MI 48201-2722
(313) 635-4213
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285043406
—
MI
Enumeration date
07/08/2024
Last updated
07/08/2024
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