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Individual

SHAVONN N BURGESS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., LPC

Contact information

Practice address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7700
Mailing address
27056 ABERDEEN ST, SOUTHFIELD, MI 48076-3667
(734) 785-7704

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401011031
MI

Other

Enumeration date
06/05/2012
Last updated
11/07/2016
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