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General NPI Number Information
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NPI Number | 1154281335
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Entity Type | Individual
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Provider Name | LISA S CALLIHAN DE VRIES LCC
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Gender | Female
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Dates
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Enumeration Date | 11/12/2025
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Last Update Date | 11/12/2025
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Provider Practice Location Address
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Address Line | 2301 S HURON PKWY STE 2B
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City | ANN ARBOR
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State | MI
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Zip | 48104-5133
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Country | US
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Telephone | 734-262-0817
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Fax |
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Provider Business Mailing Address
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Address Line | 893 CLIFFS DR
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City | YPSILANTI
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State | MI
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Zip | 48198-7332
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Country | US
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Telephone | 734-262-0817
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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 | 6451024722
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License Number State | MI
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