Most Relevant Information
Provider Data
| NPI Number: | 1003690876 |
| Provider Name: | JADA FANN |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/23/2023 |
| Last Updated: | 08/23/2023 |
Provider Practice Location
6900 E 10 MILE RD
CENTER LINE
MI
480151168
Practice Location Phone/Fax
| Phone: | 2484978527 |
| Fax: |
Provider Mailing Location
6900 E 10 MILE RD
CENTER LINE
MI
480151168
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |