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Individual

MS. LISA M DREW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PROVIDER

Contact information

Practice address
40 ELTON ST, ECORSE, MI 48229-1769
(313) 409-5675
Mailing address
40 ELTON ST, ECORSE, MI 48229-1769
(734) 756-6679

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
MI
251E00000X
Home Health Agency
Primary
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5157600
SEMI INDEPENDENT ROOMING HOUSE
MI
Enumeration date
05/23/2015
Last updated
10/22/2022
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