Individual
LATASHA STARR TRIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15300 FORDHAM ST, DETROIT, MI 48205-2956
(313) 742-9970
Mailing address
15300 FORDHAM ST, DETROIT, MI 48205-2956
(313) 742-9970
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703116020
MI
Other
Enumeration date
08/23/2021
Last updated
08/24/2021
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