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1396446316
JAISMIN LANE
WATERFORD, MI
NPI
1396446316
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-03-16
Last Update Date
2023-03-16
Business Address
JAISMIN LANE
1255 N OAKLAND BLVD
WATERFORD, MI 48327-1545
Phone number: 313-231-8554
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Mailing Address
JAISMIN LANE
8125 STANDARD
CENTER LINE, MI 48015-1361
Phone number: 313-231-8554
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