Provider Demographics
NPI:1225160005
Name:RODRIGUEZ-KITKOWSKI, LAURA LETICIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:LETICIA
Last Name:RODRIGUEZ-KITKOWSKI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43902 WOODWARD AVE
Mailing Address - Street 2:SUITE #110
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-5011
Mailing Address - Country:US
Mailing Address - Phone:248-338-1700
Mailing Address - Fax:248-335-1732
Practice Address - Street 1:43902 WOODWARD AVE
Practice Address - Street 2:SUITE #110
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5011
Practice Address - Country:US
Practice Address - Phone:248-338-1700
Practice Address - Fax:248-335-1732
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006301101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health