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General NPI Number Information
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NPI Number | 1023973302
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Entity Type | Individual
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Provider Name | LATANYA CLARKE-PRYCE
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Gender | Female
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 36681 HEATHERTON DR
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City | FARMINGTON
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State | MI
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Zip | 48335-2924
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Country | US
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Telephone | 248-923-3232
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Fax |
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Provider Business Mailing Address
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Address Line | 43000 W 9 MILE RD STE 301
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City | NOVI
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State | MI
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Zip | 48375-4129
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | A-4208809
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License Number State | MI
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