Individual
MS. SENETRA SHAYRESSE PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
59 LEANEE LN, PONTIAC, MI 48340-1651
(313) 455-1439
Mailing address
5341 LYNSUE LN, WATERFORD, MI 48327-2462
(313) 455-1439
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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