Individual
ANTOINETTE POUOKAM-LONGMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14799 DIX TOLEDO RD, SOUTHGATE, MI 48195-2507
(877) 299-1655
Mailing address
14799 DIX TOLEDO RD, SOUTHGATE, MI 48195-2507
(877) 299-1655
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704281627
MI
Other
Enumeration date
06/25/2019
Last updated
12/12/2023
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