Individual
LATERRIA TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
41521 W 11 MILE RD, NOVI, MI 48375-1803
(248) 299-0030
Mailing address
41521 W 11 MILE RD, NOVI, MI 48375-1803
(248) 299-0030
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
4704357688
MI
164W00000X
Licensed Practical Nurse
4703114466
MI
Other
Enumeration date
05/02/2017
Last updated
04/03/2024
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