Individual
TERELL SHANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12880 DOLPHIN ST APT 1, DETROIT, MI 48223-3124
(248) 915-4513
Mailing address
24225 W 9 MILE RD, SOUTHFIELD, MI 48033-3962
(248) 915-4513
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
MI
Other
Enumeration date
10/07/2025
Last updated
10/07/2025
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