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LATEASH TANIE PHILLIPS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNA

Contact information

Practice address
10410 LAKEPOINTE ST, DETROIT, MI 48224-2408
(313) 878-4349
Mailing address
10410 LAKEPOINTE ST, DETROIT, MI 48224-2408
(313) 878-4349

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
230012906461206
MI

Other

Enumeration date
11/29/2020
Last updated
11/29/2020
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