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1518264373
TIFFANY ASTRA WALLACE
DETROIT, MI
NPI
1518264373
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
(Licence: MI 6802086975)
Enumeration Date
2011-02-14
Last Update Date
2014-05-19
Business Address
Ms. TIFFANY ASTRA WALLACE LLBSW
79 W ALEXANDRINE ST
DETROIT, MI 48201-2015
Phone number: 313-831-5535
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Mailing Address
Ms. TIFFANY ASTRA WALLACE LLBSW
79 W ALEXANDRINE ST
DETROIT, MI 48201-2015
Phone number: 313-831-5535
Copy
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