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1104609692
CHANTILLE LUCKETT
WARREN, MI
NPI
1104609692
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
376K00000X Nurse's Aide
(Licence: MI 230014969350410)
Enumeration Date
2023-08-17
Last Update Date
2023-08-17
Business Address
CHANTILLE LUCKETT
27817 YVETTE DR
WARREN, MI 48088-6647
Phone number: 313-544-8101
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Mailing Address
CHANTILLE LUCKETT
27817 YVETTE DR
WARREN, MI 48088-6647
Phone number: 313-544-8101
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