Individual
MR. DAVID SHOUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACSW
Contact information
Practice address
4925 PACKARD ST, ANN ARBOR, MI 48108-1521
(734) 971-9781
Mailing address
4925 PACKARD ST, ANN ARBOR, MI 48108-1521
(734) 971-9781
(734) 971-2730
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801082191
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11879123
CAQH
—
Enumeration date
08/05/2008
Last updated
01/15/2009
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