Individual
LAWANDA HICKS AGBASSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
15357 FARMINGTON RD, SUITE 2, LIVONIA, MI 48154-2863
(313) 282-4527
Mailing address
8586 BUCKLAND DR, SOUTH LYON, MI 48178-9616
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704163985
MI
Other
Enumeration date
07/26/2006
Last updated
08/01/2016
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