Healthcare Provider Details
I. General information
NPI: 1285147983
Provider Name (Legal Business Name): EMILY DELINE-STINSON LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/16/2017
Last Update Date: 01/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
501 N MAPLE RD
ANN ARBOR MI
48103-2827
US
IV. Provider business mailing address
6549 TOWN CENTER DR STE A
CLARKSTON MI
48346-4824
US
V. Phone/Fax
- Phone: 734-669-3610
- Fax:
- Phone: 248-620-6400
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 6401016441 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: