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Individual

MISS THOMEKA T HEAGS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNA, PCT

Contact information

Practice address
21816 LAKESHIRE ST # 806081, SAINT CLAIR SHORES, MI 48081-2862
(586) 601-8097
Mailing address
21816 LAKESHIRE ST # 806081, SAINT CLAIR SHORES, MI 48081-2862
(586) 601-8097

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
MI
164X00000X
Licensed Vocational Nurse
Primary
230251200698
MI
172A00000X
Driver
MI
372500000X
Chore Provider
MI
3747A0650X
Attendant Care Provider
MI
3747P1801X
Personal Care Attendant
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1881838944
ALL MEDICAL
MI
05
1881838944
MI
Enumeration date
04/20/2009
Last updated
04/01/2019
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