Simmone Cora Arielle Derouen
Specialist in Detroit, MI. Individual provider (NPI-1).
NPI number1164032777
StatusActive
Last updated in NPPESAug 7, 2020
Details
- NPI
- 1164032777
- Entity type
- Individual (NPI-1)
- Name
- Simmone Cora Arielle Derouen
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 7, 2020
- Certification date
- Aug 7, 2020
- Last updated
- Aug 7, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
7310 Woodward AveDetroit, MI 48202-3165
Phone 313-896-1444
Mailing address
7310 Woodward Ave Ste 6Detroit, MI 48202-3165
Phone 313-896-1444
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