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General NPI Number Information
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NPI Number | 1174480008
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Entity Type | Organization
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Legal Business Name | PREMIER THERAPY SOLUTIONS
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 18119 RED OAKS DR
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City | MACOMB
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State | MI
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Zip | 48044-2776
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Country | US
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Telephone | 734-748-4826
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Fax |
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Provider Business Mailing Address
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Address Line | 18119 RED OAKS DR
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City | MACOMB
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State | MI
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Zip | 48044-2776
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | TARA SHEPARD
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Credential | LLP
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Telephone | 734-748-4826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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