Provider Demographics
NPI:1093549818
Name:STEEN, TEKEILA
Entity type:Individual
Prefix:
First Name:TEKEILA
Middle Name:
Last Name:STEEN
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 1:2785 E GRAND BLVD UNIT 247
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48211-2003
Mailing Address - Country:US
Mailing Address - Phone:810-882-8559
Mailing Address - Fax:
Practice Address - Street 1:2785 E GRAND BLVD UNIT 247
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48211-2003
Practice Address - Country:US
Practice Address - Phone:810-882-8559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health