Krystal Adams Macon, BA, SST
Case Manager/Care Coordinator in Detroit, MI. Individual provider (NPI-1).
NPI number1225784416
StatusActive
Last updated in NPPESFeb 25, 2022
Details
- NPI
- 1225784416
- Entity type
- Individual (NPI-1)
- Name
- Krystal Adams Macon
- Credential
- BA, SST
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 25, 2022
- Certification date
- Feb 25, 2022
- Last updated
- Feb 25, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | 6803088634 | MI | Yes |
Practice location
3646 Mount Elliott StDetroit, MI 48207-2311
Phone 313-331-3435
Mailing address
19712 Santa Barbara DrDetroit, MI 48221-1649
Phone 313-454-8158
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