Individual
THAISE KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
42590 STEPNITZ DR, CLINTON TOWNSHIP, MI 48036-3161
(586) 954-1838
Mailing address
5241 TWIN OAKS DR, STERLING HEIGHTS, MI 48314-3159
(586) 339-0660
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
4703123257
MI
Other
Enumeration date
08/14/2025
Last updated
08/14/2025
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