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MRS. SHATIKA COWLING LARSOSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
23071 HAWTHORNE ST, FARMINGTON, MI 48336-3330
(248) 934-1370
Mailing address
35560 GRAND RIVER AVE # 264, FARMINGTON HILLS, MI 48335-3123
(248) 934-1370

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary

Other

Enumeration date
06/04/2022
Last updated
06/04/2022
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