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General NPI Number Information
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NPI Number | 1023105426
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Entity Type | Individual
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Provider Name | LATANYA MARIE-ELVIRA EMERSON
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Gender | Female
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 8623 N WAYNE RD
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City | WESTLAND
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State | MI
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Zip | 48185-1137
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Country | US
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Telephone | 734-742-0191
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Fax |
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Provider Business Mailing Address
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Address Line | 36500 FORD RD # 211
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City | WESTLAND
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State | MI
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Zip | 48185-3769
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401009878
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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