Provider Demographics
NPI:1073683397
Name:SPIER, JEFFREY WALLACE (MA, LLP, CEAP)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:WALLACE
Last Name:SPIER
Suffix:
Gender:M
Credentials:MA, LLP, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 LAWNDALE DR
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-1142
Mailing Address - Country:US
Mailing Address - Phone:248-414-2067
Mailing Address - Fax:313-274-3010
Practice Address - Street 1:23400 MICHIGAN AVE
Practice Address - Street 2:SUITE 702
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-1924
Practice Address - Country:US
Practice Address - Phone:313-274-7010
Practice Address - Fax:313-274-3010
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 2282101YM0800X
MI009203103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling