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Individual

MELODY LACROIX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1001 MILITARY ST, PORT HURON, MI 48060-5416
(810) 985-5437
(800) 248-1568
Mailing address
1522 LAPEER AVE APT 2, PORT HURON, MI 48060-4270
(810) 333-6277

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
372600000X
ADULT COMPANION
MI
Enumeration date
11/18/2011
Last updated
11/18/2011
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