Healthcare Provider Details

I. General information

NPI: 1467811497
Provider Name (Legal Business Name): CLAUDETTE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2016
Last Update Date: 02/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18625 MUIRLAND ST
DETROIT MI
48221-2202
US

IV. Provider business mailing address

18625 MUIRLAND ST
DETROIT MI
48221-2202
US

V. Phone/Fax

Practice location:
  • Phone: 888-733-2054
  • Fax: 313-429-0283
Mailing address:
  • Phone: 888-733-2054
  • Fax: 313-429-0283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: