Individual
BRIAN WILLSHIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
251 N ROSE ST, KALAMAZOO, MI 49007-3860
(616) 228-1286
Mailing address
10031 DEER SIGHT DR, MIDDLEVILLE, MI 49333-8006
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401004052
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14135643
CAQH
MI
Enumeration date
11/20/2017
Last updated
06/16/2018
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