Individual
KAIESHA LASZETTA RIVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CLE, CLC
Contact information
Practice address
12750 FILBERT ST, DETROIT, MI 48205-3937
(313) 929-1979
Mailing address
12750 FILBERT ST, DETROIT, MI 48205-3937
(313) 929-1979
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501006796
MI
Other
Enumeration date
09/20/2020
Last updated
09/20/2020
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