Individual
JESSICA LUELLA WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2351 12 MILE RD, BERKLEY, MI 48072-1826
(248) 544-4004
Mailing address
1215 BRIARWOOD CT, WIXOM, MI 48393-4507
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/18/2015
Last updated
01/18/2015
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