Individual
RASHELLE LATISH LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14955 COLLINGHAM DR, DETROIT, MI 48205-1340
(248) 912-5767
Mailing address
14955 COLLINGHAM DR, DETROIT, MI 48205-1340
(248) 912-5767
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
37250000X
—
Other
Enumeration date
01/04/2022
Last updated
01/04/2022
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