Healthcare Provider Details

I. General information

NPI: 1154205136
Provider Name (Legal Business Name): WELLNESS FOR LEADERS INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19591 BRADY
REDFORD MI
48240-1304
US

IV. Provider business mailing address

19591 BRADY
REDFORD MI
48240-1304
US

V. Phone/Fax

Practice location:
  • Phone: 313-573-9362
  • Fax:
Mailing address:
  • Phone: 313-573-9362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRITTANY D HARVEY
Title or Position: DIRECTOR/ MANAGER
Credential: LMSW
Phone: 313-573-9362