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General NPI Number Information
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NPI Number | 1790599009
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Entity Type | Individual
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Provider Name | MAUREEN DENISE CONNOLLY
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Gender | Female
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 32001 CHERRY HILL RD
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City | WESTLAND
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State | MI
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Zip | 48186-7902
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Country | US
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Telephone | 248-884-0048
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Fax |
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Provider Business Mailing Address
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Address Line | 412 RUSTIC LN E
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City | BELLEVILLE
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State | MI
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Zip | 48111-9747
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Country | US
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Telephone | 313-624-5554
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | MI
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