Organization
EATING DISORDER TREATMENT NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA ELAINE SHIGLEY (CHIEF EXECUTIVE OFFICER)
(810) 531-1479
Entity
Organization
Contact information
Practice address
507 COLORADO AVE, MARYSVILLE, MI 48040-2544
(810) 531-1479
Mailing address
507 COLORADO AVE, MARYSVILLE, MI 48040-2544
(810) 531-1479
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
MI
Other
Enumeration date
01/11/2007
Last updated
08/22/2020
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