Individual
KESIA ELISE SHINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ND, MBA, BSHA/IS
Contact information
Practice address
15781 WILDEMERE ST, DETROIT, MI 48238-1439
(602) 460-7635
Mailing address
15781 WILDEMERE ST, DETROIT, MI 48238-1439
(602) 460-7635
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
171W00000X
Contractor
—
—
171WH0202X
Home Modifications Contractor
—
—
172V00000X
Community Health Worker
—
—
174V00000X
Clinical Ethicist
—
—
175F00000X
Naturopath
Primary
—
—
251B00000X
Case Management Agency
—
—
282J00000X
Religious Nonmedical Health Care Institution
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
374K00000X
Religious Nonmedical Practitioner
—
—
374T00000X
Religious Nonmedical Nursing Personnel
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
04/21/2025
Last updated
04/21/2025
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