Healthcare Provider Details

I. General information

NPI: 1902642499
Provider Name (Legal Business Name): EUGENA LAVETT MAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2024
Last Update Date: 09/22/2024
Certification Date: 09/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

882 OAKMAN BLVD STE C
DETROIT MI
48238-4019
US

IV. Provider business mailing address

30255 TIMBERIDGE CIR APT 301
FARMINGTON HILLS MI
48336-5448
US

V. Phone/Fax

Practice location:
  • Phone: 313-961-4890
  • Fax:
Mailing address:
  • Phone: 313-350-0915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: