Provider Demographics
NPI:1386971885
Name:WINDOWS TO THE SOUL LLC
Entity type:Organization
Organization Name:WINDOWS TO THE SOUL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAKEISHA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:248-352-6604
Mailing Address - Street 1:26160 W 12 MILE RD
Mailing Address - Street 2:APT C28
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1764
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26160 W 12 MILE RD
Practice Address - Street 2:APT C28
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1764
Practice Address - Country:US
Practice Address - Phone:248-352-6604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004525261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service