Individual
MISS STACIA LYNNETTE COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
20290 BENTLER ST, DETROIT, MI 48219-1373
(313) 384-8543
(313) 531-3056
Mailing address
20290 BENTLER ST, DETROIT, MI 48219-1373
(313) 384-8543
(313) 531-3056
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
237185110198
MI
Other
Enumeration date
03/03/2009
Last updated
03/03/2009
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