Individual
MYTIA KENCAID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16200 CARRIAGE LAMP CT APT 702, SOUTHFIELD, MI 48075-3520
(313) 523-7477
Mailing address
16200 CARRIAGE LAMP CT APT 702, SOUTHFIELD, MI 48075-3520
(313) 523-7477
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
7020815
MI
Other
Enumeration date
12/30/2013
Last updated
12/30/2013
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