Shanda Mathis
Chore Provider in Inkster, MI. Individual provider (NPI-1).
NPI number1366983975
StatusActive
Last updated in NPPESMar 15, 2017
Details
- NPI
- 1366983975
- Entity type
- Individual (NPI-1)
- Name
- Shanda Mathis
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 15, 2017
- Last updated
- Mar 15, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 372500000X | Chore Provider | – | – | Yes |
Practice location
26730 Notre Dame StInkster, MI 48141-2530
Phone 313-789-8421
Mailing address
26730 Notre Dame StInkster, MI 48141-2530
Phone 313-789-8421
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