Individual
BREANNA GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9227 OTSEGO ST, DETROIT, MI 48204-1703
(313) 784-0023
Mailing address
9227 OTSEGO ST, DETROIT, MI 48204-1703
(313) 784-0023
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
G600098149825
MI
Other
Enumeration date
05/23/2022
Last updated
05/23/2022
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