Individual
LACHELLE SOPHIA CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTER NURSE
Contact information
Practice address
14046 STAHELIN AVE, DETROIT, MI 48223-2985
(313) 549-2916
Mailing address
14046 STAHELIN AVE, DETROIT, MI 48223-2985
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
4704347124
MI
Other
Enumeration date
01/05/2020
Last updated
01/05/2020
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