Individual
MRS. LUKISHA MINGLEDOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
21751 ECORSE RD, TAYLOR, MI 48180-1846
(313) 406-4493
Mailing address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7700
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401014065
MI
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/05/2014
Last updated
08/29/2019
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