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NPI Code Detail

MEDICARE: MRS. SHELLY ANN WIEWIORA LPC

MEDICARE:  MRS. SHELLY ANN WIEWIORA  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor6401009289MI

General Provider Information

NPI Number : 1225280779
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHELLY ANN WIEWIORA LPC
Provider Business Mailing Address
First Line : 1633 PECK ST
Second Line :
City : MUSKEGON
State : MI
Zip : 49441-2530
Country : US
Telephone Number : 231-722-7770
Fax Number : 231-722-7677
Provider Business Practice Location Address
First Line : 1633 PECK ST
Second Line :
City : MUSKEGON
State : MI
Zip : 49441-2530
Country : US
Telephone Number : 231-722-7770
Fax Number : 231-722-7677
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2008
Last Update Date : 01/05/2024

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Directions to “ MRS. SHELLY ANN WIEWIORA LPC” Practice Location

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