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General NPI Number Information
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NPI Number | 1952967317
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Entity Type | Organization
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Legal Business Name | SHARI SLEBODNIK, PHD
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Dates
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Enumeration Date | 05/11/2019
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Last Update Date | 07/22/2020
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Provider Practice Location Address
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Address Line | 1700 W BIG BEAVER RD STE 200
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City | TROY
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State | MI
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Zip | 48084-3524
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Country | US
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Telephone | 586-838-0825
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Fax | 248-809-4134
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Provider Business Mailing Address
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Address Line | 24674 BERRY AVE
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City | WARREN
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State | MI
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Zip | 48089-2132
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Country | US
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Telephone | 586-838-0825
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Fax | 248-809-4134
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Authorized Official
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Title or Position | CEO/CLINICAL DIRECTOR
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Name | DR. SHARI SLEBODNIK
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Credential | PHD, LLP
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Telephone | 586-838-0825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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