Provider Demographics
NPI:1922453927
Name:SPIRDIONE, COLETTE REN (LLPC)
Entity Type:Individual
Prefix:MS
First Name:COLETTE
Middle Name:REN
Last Name:SPIRDIONE
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2593 WILLOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-9340
Mailing Address - Country:US
Mailing Address - Phone:989-965-3417
Mailing Address - Fax:
Practice Address - Street 1:1841 N OGEMAW TRL
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-9720
Practice Address - Country:US
Practice Address - Phone:989-387-1767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI247200000X
MI6401015183101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other