Provider Information for 1699168948
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YOLANDA CARPENTER
Sex: Female
NPI: 1699168948
Last Updated: 2023-10-06
Certification Date: 2023-10-06
Certification Date: 2023-10-06
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1699168948 | ||||||||||||
| Enumeration Date | 2015-03-11 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 28870 MONTEREY DR SOUTHFIELD, MI 48076-2369 United States Phone: 248-977-2794 | Fax: | ||||||||||||
| Primary Practice Address | 16210 SCHOOLCRAFT ST DETROIT, MI 48227-1739 United States Phone: 313-752-4887 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 28870 MONTEREY DR | ||||||||||||
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