Healthcare Provider Details

I. General information

NPI: 1225784010
Provider Name (Legal Business Name): MICHELE DENISE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1169 OAK VALLEY DR
ANN ARBOR MI
48108-9674
US

IV. Provider business mailing address

13195 RAWSONVILLE RD
BELLEVILLE MI
48111-9401
US

V. Phone/Fax

Practice location:
  • Phone: 734-222-9800
  • Fax:
Mailing address:
  • Phone: 734-587-2547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: