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Individual

SHATORI LAKIRAH PENNINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1403 INKSTER RD, INKSTER, MI 48141-1831
(734) 458-4601
Mailing address
43742 REVERE DR, VAN BUREN TWP, MI 48111-1671
(313) 377-8660

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
09/12/2018
Last updated
09/12/2018
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