Healthcare Provider Details

I. General information

NPI: 1295051431
Provider Name (Legal Business Name): MISS YVONNE LEE STRAND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 04/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 STEWART RD STE 105
MONROE MI
48162-5304
US

IV. Provider business mailing address

718 N MACOMB ST
MONROE MI
48162-7815
US

V. Phone/Fax

Practice location:
  • Phone: 734-240-1770
  • Fax: 734-240-1780
Mailing address:
  • Phone: 734-240-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801088306
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: