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Individual

MRS. SOPHIA LORRAINE ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
22828 GAUKLER ST, 22828 GAUKLER STREET, SAINT CLAIR SHORES, MI 48080-2543
(586) 944-0020
Mailing address
22828 GAUKLER ST, SAINT CLAIR SHORES, MI 48080-2543
(586) 944-0020

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
A536772546878
MI

Other

Enumeration date
05/18/2015
Last updated
05/18/2015
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