| Doctor Name: | MRS. THERESA LYNNE LABRANCHE |
| NPI Number: | 1154438745 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. PA C |
| License Number: | 5601002721 |
| Business Practice Address: | 8180 26 Mile Rd Suite 104 Shelby Township, MI - 483165129 |
| Business Phone Number: | 5869928300 |
| Business Fax Number: | 5869929331 |
| Mailing Address: | 8180 26 Mile Rd, Suite 104 SHELBY TOWNSHIP |
| State: | MI |
| Postal Code: | 483165129 |
| Phone Number: | 5869928300 |
| Fax Number: | 5869929331 |
| NPI Enumeration Date: | 08/23/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 5601002721 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |