Individual
MS. LAQUANDRA ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
19746 TRACEY ST, DETROIT, MI 48235-1527
(586) 350-6460
(313) 557-9779
Mailing address
19746 TRACEY ST, DETROIT, MI 48235-1527
(586) 350-6460
(313) 557-9779
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703109582
MI
Other
Enumeration date
01/01/2014
Last updated
01/01/2014
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