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General NPI Number Information
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NPI Number | 1790679710
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Entity Type | Individual
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Provider Name | ORLANDO LOVEJOY
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Gender | Male
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 12260 CAMDEN ST
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City | DETROIT
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State | MI
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Zip | 48213-1756
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Country | US
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Telephone | 248-837-5383
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Fax |
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Provider Business Mailing Address
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Address Line | 2844 LIVERNOIS RD UNIT 1051
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City | TROY
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State | MI
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Zip | 48099-7742
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Country | US
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Telephone | 313-263-8289
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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 | 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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