Individual
MRS. LILY DEJAVU LE HANDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
141 S STRATFORD RD, WINSTON SALEM, NC 27104-4213
(336) 997-9395
Mailing address
141 S STRATFORD RD, WINSTON SALEM, NC 27104-4213
(336) 997-9395
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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