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Individual

MR. IAN DAVID SHAFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, LPC

Contact information

Practice address
4025 HOLT RD STE 205, HOLT, MI 48842-6019
(517) 881-7231
Mailing address
4025 HOLT RD STE 205, HOLT, MI 48842-6019
(517) 881-7231

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401012915
MI
101YM0800X
Mental Health Counselor
6401012915
MI
101YP2500X
Professional Counselor
Primary
6401012915
MI

Other

Enumeration date
11/12/2014
Last updated
11/07/2023
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