Individual
JALEESA GOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23720 NORMANDY AVE, EASTPOINTE, MI 48021-1858
(313) 442-3199
Mailing address
23720 NORMANDY AVE, EASTPOINTE, MI 48021-1858
(313) 442-3199
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703113602
MI
Other
Enumeration date
10/03/2016
Last updated
10/03/2016
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