NPI 1104290626

Kelly Whittaker, MS

Practitioner Case Management Agency Detroit, MI

Practice location

Address: 16747 Shaftsbury Ave, Detroit, MI 48219-4012
Phone: (313) 971-4318

Registered specialties

Case Management Agency Primary

Agencies Taxonomy 251B00000X

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Registry record

NPI: 1104290626
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Nov 2015
Record last updated: 20 Nov 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.