Individual
JUSTIN MARK SHOUNIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLBSW
Contact information
Practice address
8600 WOODWARD AVE, DETROIT, MI 48202-2142
(313) 875-7601
Mailing address
8106 CHESAPEAKE CIR, WALLED LAKE, MI 48390-5903
(248) 444-2270
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802087730
MI
Other
Enumeration date
04/16/2015
Last updated
04/16/2015
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