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NPI Code Detail

MEDICARE: MS. ERICA CROSBY LLP

MEDICARE: MS. ERICA CROSBY LLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist6361000500MI

General Provider Information

NPI Number : 1831632793
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ERICA CROSBY LLP
Provider Business Mailing Address
First Line : 1 HERITAGE DR STE 261
Second Line :
City : SOUTHGATE
State : MI
Zip : 48195-2574
Country : US
Telephone Number : 734-778-0663
Fax Number :
Provider Business Practice Location Address
First Line : 1 HERITAGE DR STE 261
Second Line :
City : SOUTHGATE
State : MI
Zip : 48195-2574
Country : US
Telephone Number : 347-780-6637
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2016
Last Update Date : 09/02/2022

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