Provider Demographics
NPI:1023750338
Name:DEVEZIN, JARONIQUE DANIELLE (EDD)
Entity type:Individual
Prefix:DR
First Name:JARONIQUE
Middle Name:DANIELLE
Last Name:DEVEZIN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25091 FRIAR LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-2766
Mailing Address - Country:US
Mailing Address - Phone:313-333-4073
Mailing Address - Fax:
Practice Address - Street 1:25091 FRIAR LN
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-2766
Practice Address - Country:US
Practice Address - Phone:313-333-4073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator