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General NPI Number Information
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NPI Number | 1093660011
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Entity Type | Organization
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Legal Business Name | D&M WELLNESS GROUP
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Dates
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Enumeration Date | 03/04/2026
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 19115 SURREY LN BLDG 3
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City | NORTHVILLE
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State | MI
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Zip | 48167-3136
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Country | US
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Telephone | 313-518-4613
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Fax |
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Provider Business Mailing Address
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Address Line | 19115 SURREY LN BLDG 3
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City | NORTHVILLE
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State | MI
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Zip | 48167-3136
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Country | US
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Telephone | 313-518-4613
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. DEJUAN WILLIAMS SR.
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Credential | CHW, CPRC, CPT, NT
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Telephone | 313-518-4613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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