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General NPI Number Information
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NPI Number | 1235658535
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Entity Type | Individual
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Provider Name | LATRICE ROBINSON MA, LLP
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Gender | Female
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Dates
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Enumeration Date | 09/18/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 23231 WOODWARD AVE
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City | FERNDALE
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State | MI
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Zip | 48220-1361
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Country | US
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Telephone | 248-750-6556
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Fax |
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Provider Business Mailing Address
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Address Line | 18700 W 10 MILE RD STE 2900
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2612
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Country | US
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Telephone | 248-750-6556
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301016612
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License Number State | MI
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