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General NPI Number Information
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NPI Number | 1568826105
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Entity Type | Individual
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Provider Name | BOBBY STINNETTE LPC
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Gender | Male
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Dates
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Enumeration Date | 04/10/2016
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Last Update Date | 04/10/2016
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Provider Practice Location Address
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Address Line | 19111 W 10 MILE RD SUITE 224
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2417
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Country | US
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Telephone | 248-721-4608
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Fax |
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Provider Business Mailing Address
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Address Line | 555 BRUSH ST APT 1807
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City | DETROIT
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State | MI
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Zip | 48226-4355
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Country | US
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Telephone | 202-459-3476
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401014155
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License Number State | MI
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