Individual
MS. LAKISHA MICHELLE MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18795 LACROSSE AVE, LATHRUP VILLAGE, MI 48076-2527
(313) 850-9414
Mailing address
18795 LACROSSE AVE, LATHRUP VILLAGE, MI 48076-2527
(313) 850-9414
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/04/2016
Last updated
06/04/2016
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