Individual
DEZHANAE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12470 SIDONIE AVE, WARREN, MI 48089-3167
(313) 523-7529
Mailing address
12470 SIDONIE AVE, WARREN, MI 48089-3167
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703127137
MI
Other
Enumeration date
09/13/2023
Last updated
09/13/2023
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