Individual
ROBERT E ENNIS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
129 E 3RD ST, FLINT, MI 48502-1728
(810) 233-4031
(810) 237-4141
Mailing address
12190 SILVER LAKE RD, BYRON, MI 48418-9001
(810) 233-4031
(810) 237-4141
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6801010482
MI
101YA0400X
Addiction (Substance Use Disorder) Counselor
6801010482
MI
101YM0800X
Mental Health Counselor
Primary
6801010482
MI
101YP2500X
Professional Counselor
6801010482
MI
106H00000X
Marriage & Family Therapist
6801010482
MI
Other
Enumeration date
08/29/2011
Last updated
08/29/2011
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