Individual
DEANDRA JUTILA-WALDRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
215 NORTH AVE # 200, MOUNT CLEMENS, MI 48043-1716
(586) 307-9010
Mailing address
36986 DIVISION RD APT 2, RICHMOND, MI 48062-5417
(586) 873-4709
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
MI
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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