Provider Demographics
NPI:1497510762
Name:CAYCE, WRENETHA DARNISE
Entity Type:Individual
Prefix:
First Name:WRENETHA
Middle Name:DARNISE
Last Name:CAYCE
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 1:22098 INKSTER RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3524
Mailing Address - Country:US
Mailing Address - Phone:248-787-0546
Mailing Address - Fax:248-905-3334
Practice Address - Street 1:22098 INKSTER RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-3524
Practice Address - Country:US
Practice Address - Phone:248-787-0546
Practice Address - Fax:248-905-3334
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker