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Individual

MS. LAWREESE DESHAN SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NURSE AIDE

Contact information

Practice address
16242 MANOR ST, DETROIT, MI 48221-2859
(313) 982-2406
Mailing address
16242 MANOR ST, DETROIT, MI 48221-2859
(313) 982-2406

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
MI000057051
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
84453581
MI
Enumeration date
08/18/2020
Last updated
08/18/2020
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