Provider Demographics
NPI:1003471160
Name:CHRISTINA L SHOEMAKER LLC
Entity Type:Organization
Organization Name:CHRISTINA L SHOEMAKER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHOEMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:248-506-3399
Mailing Address - Street 1:29540 SOUTHFIELD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2047
Mailing Address - Country:US
Mailing Address - Phone:248-506-3399
Mailing Address - Fax:
Practice Address - Street 1:29540 SOUTHFIELD RD STE 101
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2047
Practice Address - Country:US
Practice Address - Phone:248-506-3399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-04
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty