Individual
MR. CODY WILLIAM SHINAVIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
6549 TOWN CENTER DR STE A, CLARKSTON, MI 48346
(248) 620-6400
Mailing address
6549 TOWN CENTER DR STE A, CLARKSTON, MI 48346-4824
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704285216
MI
Other
Enumeration date
10/26/2018
Last updated
02/25/2019
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