Individual provider · NPI-1

Chantia Dallas

Case Management · Livonia, MI

NPI number1487460754
StatusActive
Last updated in NPPESDec 10, 2024

Details

NPI
1487460754
Entity type
Individual (NPI-1)
Name
Chantia Dallas
Sex
Female
Sole proprietor
Yes
Enumeration date
Dec 10, 2024
Certification date
Dec 10, 2024
Last updated
Dec 10, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251B00000X Case Management––Yes

Practice location

37450 Schoolcraft Rd Ste 110
Livonia, MI 48150-1000

Phone 734-458-4601

Mailing address

30931 Fernwood St
Westland, MI 48186-5097

Phone 734-765-7709

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