Individual
MRS. YVONNE TANTANEISHA YOUNGBLOOD-LASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
38 S HIGHLAND ST, MOUNT CLEMENS, MI 48043-2140
(989) 737-8752
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703119329
MI
Other
Enumeration date
09/15/2025
Last updated
09/15/2025
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