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General NPI Number Information
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NPI Number | 1477862092
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Entity Type | Organization
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Legal Business Name | MIRACLES FOR MOM'S AND BABES
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Dates
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Enumeration Date | 09/30/2010
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Last Update Date | 09/30/2010
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Provider Practice Location Address
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Address Line | 31843 KINGSWOOD SQ
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-1221
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Country | US
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Telephone | 313-289-2637
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Fax |
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Provider Business Mailing Address
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Address Line | 31843 KINGSWOOD SQ
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-1221
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Country | US
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Telephone | 313-289-2637
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Fax |
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Authorized Official
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Title or Position | COORDINATOR
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Name | ELIZA YULONDA ASHLEY
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Credential | LBSW, MA
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Telephone | 248-432-7385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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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 | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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