Individual
LASONJI DONIKA SOUTHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OWNER/CEO
Contact information
Practice address
128 W DEWEY ST, FLINT, MI 48505-4034
(810) 931-8722
Mailing address
128 W DEWEY ST, FLINT, MI 48505-4034
(810) 931-8722
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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