Individual
ROSHELLE DESHAWN PETTIFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19101 EVERGREEN RD APT 506, DETROIT, MI 48219-2682
(313) 918-6623
Mailing address
19101 EVERGREEN RD APT 506, DETROIT, MI 48219-2682
(313) 918-6623
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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