Healthcare Provider Details

I. General information

NPI: 1881386662
Provider Name (Legal Business Name): MR. GREGORY DEVOIRE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 05/24/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43000 W 9 MILE RD STE 209
NOVI MI
48375-4132
US

IV. Provider business mailing address

6022 ALDINGBROOKE CIRCLE RD N
WEST BLOOMFIELD MI
48322-1307
US

V. Phone/Fax

Practice location:
  • Phone: 314-971-1515
  • Fax:
Mailing address:
  • Phone: 314-971-1515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401225253
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: