Individual
O'LESA DENNETTE ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25750 LAHSER RD, SOUTHFIELD, MI 48033-5809
(248) 415-2500
Mailing address
25750 LAHSER RD, SOUTHFIELD, MI 48033-5809
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501006879
MI
Other
Enumeration date
04/04/2019
Last updated
04/04/2019
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