Individual
MRS. LAKECHA MARHONDA TRIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14799 DIX TOLEDO RD, SOUTHGATE, MI 48195-2507
(734) 324-8326
Mailing address
28467 OAKWOOD AVE, FLAT ROCK, MI 48134-9763
(248) 914-4169
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TRIPPLA
—
MI
Enumeration date
12/13/2011
Last updated
04/16/2013
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