Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | MI | |
Y | 103TC1900X | Counseling Psychologist | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1023312857 |
---|---|
Provider Name | Emerson Lane Delacroix |
First Address | Ypsilanti, MI 48197-3318 |
Second Address | Ypsilanti, MI 48197-3318 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2011 |
Last Update Date | 05/10/2021 |