Most Relevant Information
Provider Data
| NPI Number: | 1003309063 |
| Provider Name: | MARQUITA OUTLAW RN |
| Entity Type: | Individual |
| Taxonomy Code: | 251C00000X |
| Specialty: | Day Training, Developmentally Disabled Services |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/13/2018 |
| Last Updated: | 07/14/2018 |
Provider Practice Location
8290 COYLE ST
DETROIT
MI
48228
Practice Location Phone/Fax
| Phone: | 3135108545 |
| Fax: |
Provider Mailing Location
3319 GREENFIELD RD # 145
DEARBORN
MI
481201212
Provider Mailing Phone/Fax
| Phone: | 3136380038 |
| Fax: |