Individual
KIESA WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OWNER
Contact information
Practice address
15375 JULIANA AVE, EASTPOINTE, MI 48021-3607
(586) 665-3055
Mailing address
15375 JULIANA AVE, EASTPOINTE, MI 48021-3607
(586) 665-3055
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
03/11/2026
Last updated
03/11/2026
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