Healthcare Provider Details

I. General information

NPI: 1841089307
Provider Name (Legal Business Name): EMILY LAUZON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 SAINT ANTOINE ST STE 5B
DETROIT MI
48201-2153
US

IV. Provider business mailing address

19783 GARY LN
LIVONIA MI
48152-1168
US

V. Phone/Fax

Practice location:
  • Phone: 313-996-0639
  • Fax: 313-745-8165
Mailing address:
  • Phone: 248-207-7193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: