Provider Demographics
NPI:1871902205
Name:WILLINGHAM, ARLANZZIA CHANISH
Entity type:Individual
Prefix:
First Name:ARLANZZIA
Middle Name:CHANISH
Last Name:WILLINGHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36536 JEFFERSON CT APT 12103
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-1933
Mailing Address - Country:US
Mailing Address - Phone:586-744-8444
Mailing Address - Fax:313-285-9536
Practice Address - Street 1:36536 JEFFERSON CT APT 12103
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-1933
Practice Address - Country:US
Practice Address - Phone:586-744-8444
Practice Address - Fax:313-285-9536
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver