Individual
MS. PAULETTE MARIA LASALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN CNP
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2600
Mailing address
1057 HERITAGE RD, KINGSVILLE, ONTARIO N9Y2E-6
(519) 733-3167
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704124035
MI
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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