Individual
SHASTA LATISHA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
37469 CHARTER OAKS BLVD, CLINTON TWP, MI 48036-2415
(313) 247-2707
(313) 247-2707
Mailing address
37469 CHARTER OAKS BLVD, CLINTON TWP, MI 48036-2415
(313) 247-2707
(313) 247-2707
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
4704405379
MI
Other
Enumeration date
02/13/2026
Last updated
02/13/2026
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