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General NPI Number Information
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NPI Number | 1013751874
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Entity Type | Individual
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Provider Name | ALLISON SHAUNE
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Gender | Female
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Dates
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Enumeration Date | 06/25/2024
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 13001 23 MILE RD STE 103
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48315-2767
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Country | US
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Telephone | 124-848-3050
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Fax |
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Provider Business Mailing Address
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Address Line | 530 E MELDRUM CIR
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City | SAINT CLAIR
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State | MI
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Zip | 48079-4245
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Country | US
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Telephone | 810-824-0739
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6451024292
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License Number State | MI
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