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General NPI Number Information
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NPI Number | 1609073527
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Entity Type | Organization
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Legal Business Name | SHEILA J EATON PC
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 05/21/2009
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Provider Practice Location Address
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Address Line | 31201 CHICAGO RD S SUITE A102
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City | WARREN
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State | MI
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Zip | 48093-5527
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Country | US
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Telephone | 586-795-4750
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Fax |
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Provider Business Mailing Address
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Address Line | 14444 TALBOT DR
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City | WARREN
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State | MI
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Zip | 48088-7412
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Country | US
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Telephone | 586-498-8583
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHEILA JOYCE EATON
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Credential | PH.D.
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Telephone | 586-795-4750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301006308
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License Number State | MI
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