Healthcare Provider Details

I. General information

NPI: 1952862153
Provider Name (Legal Business Name): TONJA Y LAWRENCE LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 03/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UZANI COUNSELING AND CONSULTING, LLPC 29556 SOUTHFIELD RD, SUITE 200
SOUTHFIELD MI
48076-4807
US

IV. Provider business mailing address

25263 MUERLAND RD
SOUTHFIELD MI
48033-5359
US

V. Phone/Fax

Practice location:
  • Phone: 248-750-8976
  • Fax:
Mailing address:
  • Phone: 248-622-6776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401016958
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: