Provider Demographics
NPI:1689810871
Name:BULL, LINDA MARIE-LATRONICA (LLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:MARIE-LATRONICA
Last Name:BULL
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:MISS
Other - First Name:LINDA
Other - Middle Name:MARIE
Other - Last Name:LATRONICA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLP
Mailing Address - Street 1:850 W UNIVERSITY DR STE C
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1845
Mailing Address - Country:US
Mailing Address - Phone:248-601-3111
Mailing Address - Fax:
Practice Address - Street 1:850 W UNIVERSITY DR STE C
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1845
Practice Address - Country:US
Practice Address - Phone:248-601-3111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-18
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011942103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral