Individual
RENEE WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
751 E GRAND BLVD, DETROIT, MI 48207-2529
(313) 922-2222
Mailing address
9354 PENROD ST, DETROIT, MI 48228-1833
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4704157276
MI
101YM0800X
Mental Health Counselor
Primary
4704157276
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704157276
NURSING
MI
Enumeration date
03/21/2007
Last updated
09/11/2025
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