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Individual

MR. EDWARD FIELDS IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LLPC

Contact information

Practice address
36975 UTICA RD, CLINTON TOWNSHIP, MI 48036-1685
(586) 596-2605
Mailing address
36975 UTICA RD STE 104, CLINTON TOWNSHIP, MI 48036-1685

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401016526
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05
MI
Enumeration date
12/06/2018
Last updated
12/06/2018
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