Individual
SHELBY BOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLMSW
Contact information
Practice address
29877 TELEGRAPH RD STE 400, SOUTHFIELD, MI 48034-7661
(248) 294-0539
Mailing address
29877 TELEGRAPH RD STE 400, SOUTHFIELD, MI 48034-7661
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6851121040
MI
Other
Enumeration date
12/09/2025
Last updated
12/09/2025
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