Healthcare Provider Details

I. General information

NPI: 1871287599
Provider Name (Legal Business Name): BRITTANY ALEXANDRA REID
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2023
Last Update Date: 05/09/2024
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10809 MACK AVE
DETROIT MI
48214-2119
US

IV. Provider business mailing address

10809 MACK AVE
DETROIT MI
48214-2119
US

V. Phone/Fax

Practice location:
  • Phone: 313-824-1000
  • Fax:
Mailing address:
  • Phone: 313-824-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: