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1154037687
LANISE MOODY
GRAND RAPIDS, MI
NPI
1154037687
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2023-01-27
Last Update Date
2023-01-27
Business Address
LANISE MOODY
4218 BURTON ST SE
GRAND RAPIDS, MI 49546-6121
Phone number: 616-301-8000
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Mailing Address
LANISE MOODY
645 W WILLOW ST APT 305
LANSING, MI 48906-4752
Phone number: 517-507-8866
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