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General NPI Number Information
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NPI Number | 1124466388
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Entity Type | Individual
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Provider Name | LATOYA THOMPSON LLPC
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Gender | Female
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Dates
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Enumeration Date | 06/10/2013
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Last Update Date | 06/10/2013
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Provider Practice Location Address
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Address Line | 3906 BALDWIN RD UNIT 210483
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City | AUBURN HILLS
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State | MI
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Zip | 48321-7769
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Country | US
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Telephone | 810-771-8878
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 210483
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City | AUBURN HILLS
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State | MI
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Zip | 48321-0483
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6401012218
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License Number State | MI
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