Individual
LATISHA LEE HUCKABY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12501 HAMILTON AVE, HIGHLAND PARK, MI 48203-3243
(313) 518-7566
Mailing address
12501 HAMILTON AVE, HIGHLAND PARK, MI 48203-3243
(313) 518-7566
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703126862
MI
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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