Individual
SHAMARCO BRANCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8623 N WAYNE RD, #200, WESTLAND, MI 48185-1137
(734) 458-4601
Mailing address
43874 TIMBERVIEW CT, BELLEVILLE, MI 48111-2844
(810) 853-1238
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
10/11/2016
Last updated
10/11/2016
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