Individual
IEASHIA MENDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
269 WALKER ST, DETROIT, MI 48207-4258
(404) 518-6215
Mailing address
269 WALKER ST, DETROIT, MI 48207-4258
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
4703118007
MI
311500000X
Alzheimer Center (Dementia Center)
Primary
—
—
Other
Enumeration date
12/21/2017
Last updated
12/21/2017
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