Individual
LAKESHIA GRAYS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7155 NW 179TH ST APT 110, HIALEAH, FL 33015-6112
(786) 694-8956
Mailing address
PO BOX 12166, MIAMI, FL 33101-2166
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
824551386
WIG MANUFACTURER
FL
Enumeration date
02/05/2021
Last updated
02/05/2021
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