Individual
TANESHA SHAWNTAY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20998 WESTHAVEN AVE, SOUTHFIELD, MI 48075-7931
(313) 208-1685
Mailing address
20145 ROSELAND ST, SOUTHFIELD, MI 48076-5458
(313) 208-1685
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
AS630404863
MI
Other
Enumeration date
07/20/2021
Last updated
07/20/2021
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