Healthcare Provider Details

I. General information

NPI: 1972432953
Provider Name (Legal Business Name): THY WHOLE SELF HEALTH AND LIFE COACHING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24801 5 MILE RD STE 25
REDFORD MI
48239-3653
US

IV. Provider business mailing address

24801 5 MILE RD STE 25
REDFORD MI
48239-3653
US

V. Phone/Fax

Practice location:
  • Phone: 313-251-4471
  • Fax: 855-500-0701
Mailing address:
  • Phone:
  • Fax: 855-500-0701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHALINA NEVINS
Title or Position: CEO
Credential: FNP
Phone: 313-251-4471