Individual
LAKENYA S LARRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1110 ELDON BAKER DR, FLINT, MI 48507-1923
(810) 232-2766
Mailing address
8285 S SAGINAW ST STE 7, GRAND BLANC, MI 48439-2436
(810) 321-3001
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/06/2019
Last updated
12/04/2020
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