Individual
MS. KAHLIA VAILLANCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
8693 HARDWOOD DR, BELLEVILLE, MI 48111-7413
(702) 265-0840
Mailing address
8693 HARDWOOD DR, BELLEVILLE, MI 48111-7413
(702) 265-0840
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703102287
MI
Other
Enumeration date
06/04/2016
Last updated
06/04/2016
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