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Organization
EMERALDS RADIANT LIFE-STYLE LLC
Active
Organization
EMERALDS RADIANT LIFE-STYLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MALINDA LATICHA WILSON LMSW (SOCIAL WORKER, PROVIDER)
(248) 860-0784
Entity
Organization
Contact information
Practice address
18726 MIDWAY AVE, SOUTHFIELD, MI 48075-7143
(248) 860-0784
Mailing address
19785 W 12 MILE RD # 412, SOUTHFIELD, MI 48076-2584
(248) 860-0784
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/23/2026
Last updated
03/23/2026
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