Individual
LAKEISHA SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
12645 HALLUM ST, DALLAS, TX 75243-1857
(972) 748-6206
Mailing address
12645 HALLUM ST, DALLAS, TX 75243-1857
(972) 748-6206
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
212452
TX
Other
Enumeration date
07/16/2018
Last updated
07/16/2018
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