Individual
MS. LAKEYA NICO MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
13101 ALLEN, SOUTHGATE, MI 48195
(734) 785-7700
Mailing address
13101 ALLEN, SOUTHGATE, MI 48195
(734) 785-7700
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
6803085385
MI
Other
Enumeration date
05/12/2009
Last updated
09/12/2016
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