Individual
JENCY DICKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
7350 CHURCHILL ST, DETROIT, MI 48206-2614
(313) 826-9744
Mailing address
7350 CHURCHILL ST, DETROIT, MI 48206-2614
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703094700
MI
Other
Enumeration date
08/02/2010
Last updated
08/02/2010
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