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General NPI Number Information
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NPI Number | 1891061057
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Entity Type | Organization
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Legal Business Name | JAMES P SISLEY MA LMFT PLLC
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Dates
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Enumeration Date | 03/31/2012
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Last Update Date | 03/31/2012
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Provider Practice Location Address
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Address Line | 250 W EISENHOWER PKWY STE 190
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City | ANN ARBOR
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State | MI
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Zip | 48103-6933
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Country | US
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Telephone | 734-757-8164
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Fax |
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Provider Business Mailing Address
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Address Line | 250 W EISENHOWER PKWY STE 190
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City | ANN ARBOR
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State | MI
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Zip | 48103-6933
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Country | US
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Telephone | 734-757-8164
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Fax |
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Authorized Official
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Title or Position | LMFT
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Name | MR. JAMES PERRY SISLEY
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Credential | MA
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Telephone | 734-757-8164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 4101006474
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License Number State | MI
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