Individual
JALEESA EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12866 OMAHA ST, DETROIT, MI 48217-1093
(313) 414-3281
Mailing address
12866 OMAHA ST, DETROIT, MI 48217-1093
(313) 414-3281
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
05/07/2016
Last updated
05/07/2016
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