Provider Demographics
NPI:1902130966
Name:BARLOW, LASONIA ADRENE (LLPC)
Entity Type:Individual
Prefix:MRS
First Name:LASONIA
Middle Name:ADRENE
Last Name:BARLOW
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22431 TROJAN ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-6210
Mailing Address - Country:US
Mailing Address - Phone:313-310-4181
Mailing Address - Fax:
Practice Address - Street 1:22431 TROJAN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-6210
Practice Address - Country:US
Practice Address - Phone:313-310-4181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011509101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional