OrganizationActive
Living4life Wellnessllc
NPI 1750771200 · Metabolic Nutrition Registered Dietitian · Detroit, MI
Provider details
- NPI number
- 1750771200
- Entity type
- Organization
- Primary specialty
- Metabolic Nutrition Registered DietitianDietary & Nutritional Service Providers
- Organization subpart
- No
- Authorized official
- Doniss Hicks, President/Wellness Specialist(313) 618-7454
- License
- 812531 (MI)
Specialties & taxonomies
Dietary & Nutritional Service Providers
Practice location
11085 Mckinney St
Detroit, MI 48224-1112
Phone: (313) 618-7454
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 241603
Detroit, MI 48224-5603
Registry dates
- Enumerated
- 2015-02-04
- Last updated
- 2015-02-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.