Healthcare Provider Details

I. General information

NPI: 1841982386
Provider Name (Legal Business Name): SHILOH NEVAEH TORRES TLLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2023
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 WELCH RD
COMMERCE TWP MI
48390-1562
US

IV. Provider business mailing address

5777 W MAPLE RD STE 100
WEST BLOOMFIELD MI
48322-2268
US

V. Phone/Fax

Practice location:
  • Phone: 248-767-7927
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6362010446
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: