Individual
MRS. SHANNON EILEEN MARTTILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, CADCM, CCSM
Contact information
Practice address
3139 W. HURON, WATERFORD, MI 48328
(248) 738-8400
(248) 738-8404
Mailing address
5832 OSTER DR, WATERFORD, MI 48327-2648
(248) 738-0319
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/30/2006
Last updated
05/05/2014
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