Provider Demographics
NPI:1710479704
Name:BABCOCK, YOSHIKO (LLP)
Entity Type:Individual
Prefix:
First Name:YOSHIKO
Middle Name:
Last Name:BABCOCK
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51145 SUNDAY DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-9148
Mailing Address - Country:US
Mailing Address - Phone:248-872-1579
Mailing Address - Fax:
Practice Address - Street 1:51145 SUNDAY DR
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-9148
Practice Address - Country:US
Practice Address - Phone:248-872-1579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2022-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013034103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling