Individual
AMONIQUE ELIZABETH SUBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
19130 APPLETON ST, DETROIT, MI 48219-5612
(586) 444-9472
Mailing address
PO BOX 226, ROSEVILLE, MI 48066-0226
(586) 444-9472
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
4703120460
MI
246RP1900X
Phlebotomy Technician
Primary
R2L6G7J3
MI
Other
Enumeration date
05/10/2021
Last updated
12/31/2021
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