Organization
CENTRIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JALONDA DUKES (ABA)
(810) 893-1877
Entity
Organization
Contact information
Practice address
3051 COURTZ ISLE APT 5, FLINT, MI 48532-4207
(810) 893-1877
Mailing address
3051 COURTZ ISLE APT 5, FLINT, MI 48532-4207
(810) 893-1877
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
242700000X
TECHNICIAN-OTHER
MI
Enumeration date
05/23/2016
Last updated
05/23/2016
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