Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156F00000X | Technician/Technologist | ||
Y | 156F00000X | Technician/Technologist | MI |
NPI | 1316412752 |
---|---|
Provider Name | Monea Howard |
First Address | Bingham Farms, MI 48025-2454 |
Second Address | Bingham Farms, MI 48025-2454 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2018 |
Last Update Date | 12/10/2018 |