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Individual

JALEESA WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
X

Contact information

Practice address
18696 INDIANA ST, DETROIT, MI 48221-2050
(313) 493-2702
Mailing address
18696 INDIANA ST, DETROIT, MI 48221-2050

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703124504
MI

Other

Enumeration date
09/18/2025
Last updated
09/18/2025
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