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General NPI Number Information
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NPI Number | 1275448045
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Entity Type | Individual
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Provider Name | MICHELLE RENAUD PHD
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Gender | Female
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Dates
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Enumeration Date | 08/17/2026
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Last Update Date | 08/17/2026
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Provider Practice Location Address
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Address Line | 10544 LASALLE BLVD
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City | HUNTINGTON WOODS
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State | MI
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Zip | 48070-1164
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Country | US
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Telephone | 313-715-7709
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 W FORT ST UNIT 442451
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City | DETROIT
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State | MI
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Zip | 48244-3599
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Country | US
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Telephone | 313-715-7709
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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