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General NPI Number Information
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NPI Number | 1861982340
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Entity Type | Individual
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Provider Name | CECELIA MCDONALD
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Gender | Female
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Dates
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Enumeration Date | 05/10/2018
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Last Update Date | 08/01/2023
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Provider Practice Location Address
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Address Line | 20007 MCCORMICK ST
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City | DETROIT
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State | MI
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Zip | 48224-1147
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Country | US
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Telephone | 313-372-1609
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 36066
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City | GROSSE POINTE FARMS
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State | MI
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Zip | 48236-0066
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Country | US
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Telephone | 313-244-1863
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 821640527
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License Number State | MI
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