Individual
MRS. LETICIA MOTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1940 CAMPBELL ST, DETROIT, MI 48209-2125
(313) 551-0707
(313) 551-0708
Mailing address
1940 CAMPBELL ST, DETROIT, MI 48209-2125
(313) 551-0707
(313) 551-0708
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4916160
—
MI
Enumeration date
10/05/2006
Last updated
02/21/2025
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