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1861269292
LAKEISHA ANN LONGINO
MATTESON, IL
NPI
1861269292
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
374K00000X Religious Nonmedical Practitioner
Enumeration Date
2023-12-06
Last Update Date
2023-12-06
Business Address
LAKEISHA ANN LONGINO
103 HUNTINGWOOD RD
MATTESON, IL 60443-1134
Phone number: 312-498-4551
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Mailing Address
LAKEISHA ANN LONGINO
103 HUNTINGWOOD RD
MATTESON, IL 60443-1134
Phone number: 312-498-4551
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