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1194581751
JELISA TAMARIA LOCKETT
GRAND RAPIDS, MI
NPI
1194581751
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2024-02-22
Last Update Date
2024-02-22
Business Address
JELISA TAMARIA LOCKETT
4218 BURTON SE
GRAND RAPIDS, MI 49546
Phone number: 920-918-2453
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Mailing Address
JELISA TAMARIA LOCKETT
4218 BURTON SE
GRAND RAPIDS, MI 49546
Phone number:
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