Individual
DATRICE LESHAY RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8064 KENSINGTON BLVD APT 171, DAVISON, MI 48423-2908
(313) 461-6196
Mailing address
8064 KENSINGTON BLVD APT 171, DAVISON, MI 48423-2908
(313) 461-6196
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
06/25/2021
Last updated
06/25/2021
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