Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | MH 2282 | FL |
N | 103TC1900X | Counseling Psychologist | 009203 | MI |
NPI | 1073683397 |
---|---|
Provider Name | Mr. Jeffrey Wallace Spier |
First Address | Royal Oak, MI 48067-1142 |
Second Address | Dearborn, MI 48124-1924 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 08/07/2007 |