Individual
RAKIYA LASCHELL MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
43 W AUBURN ST, ECORSE, MI 48229-1803
(313) 269-7816
Mailing address
43 W AUBURN ST, ECORSE, MI 48229-1803
(313) 269-7816
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703114564
MI
Other
Enumeration date
06/23/2022
Last updated
06/23/2022
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