Individual
YIESHA LACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10945 WHITEHILL ST, DETROIT, MI 48224-2458
(313) 459-3267
Mailing address
10945 WHITEHILL ST, DETROIT, MI 48224-2458
(313) 459-3267
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703118137
MI
Other
Enumeration date
04/02/2018
Last updated
04/02/2018
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