Individual
MS. LATISHA BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
58 HILL ST, RIVER ROUGE, MI 48218-1537
(313) 138-2820
Mailing address
58 HILL ST, RIVER ROUGE, MI 48218-1537
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
MI
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
MI
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
04/13/2012
Last updated
07/14/2023
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