Healthcare Provider Details

I. General information

NPI: 1164277711
Provider Name (Legal Business Name): ALISHA L BISNETT LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2024
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9844 DIXIE HWY
IRA MI
48023-2813
US

IV. Provider business mailing address

3690 STATE RD
FORT GRATIOT MI
48059-4064
US

V. Phone/Fax

Practice location:
  • Phone: 586-716-7600
  • Fax:
Mailing address:
  • Phone: 810-956-2867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6451023572
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: