Individual
GWENDOLYN K LA CROIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC, RN
Contact information
Practice address
410 NORTH ST, MILAN, MI 48160-1354
(313) 590-9296
Mailing address
401 NORTH ST, MILAN, MI 48160-1353
(313) 999-4499
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704285632
MI
Other
Enumeration date
09/07/2016
Last updated
05/06/2024
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