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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LATONYA WALLACE-HARDIMAN, BA, MSA

Active Sole Proprietor

LATONYA WALLACE-HARDIMAN, BA, MSA is a Pain Clinic healthcare provider located in DETROIT, Michigan. NPI 1053818039 is currently active in the NPPES registry. Verify at CMS.

Pain Clinic · DETROIT, MI

Registration Details

NPI Number
1053818039
Provider Type
Individual
Gender
Female
NPI Issued
Apr 6, 2018 (8.3812944272203 yrs)
Last Updated
Dec 17, 2020
Sole Proprietor
Yes

Practice Information

Address
5830 CONNER ST
DETROIT, MI, 482133458
Browse MI providers · Browse ZIP 48213
Phone
3139241456
Fax
3136362290
Primary Specialty
Pain Clinic
261QP3300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.