Individual
MABELL OMOYE SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
724 OWL COURT, WOLVERINE LAKE, MI 48390
(313) 675-5341
Mailing address
724 OWL CT, WOLVERINE LAKE, MI 48390-3066
(313) 675-5341
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
4703110100
MI
251E00000X
Home Health Agency
—
—
Other
Enumeration date
01/02/2014
Last updated
01/02/2014
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