Individual
ANGELIQUE LASHA MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9556 PUCKER ST, BERRIEN CENTER, MI 49102-9717
(269) 635-3769
(269) 213-3303
Mailing address
9556 PUCKER ST, BERRIEN CENTER, MI 49102-9717
(269) 635-3769
(269) 213-3303
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
AS1110418243
MI
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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