Individual provider · Type 1 NPI
Shelby Qualls, CAC-1
Addiction (Substance Use Disorder) Counselor · Detroit, MI
NPI number
1194847749
Active
Practice location
8809 John C Lodge
Detroit, MI 48224
Fax (313) 876-0532
Mailing address
10520 Morang Dr
Detroit, MI 48224-1840
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 820080 (MI) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1194847749
Shelby Qualls, CAC-1's National Provider Identifier is 1194847749, issued on Apr 4, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Detroit, MI. The record was last updated on Jul 8, 2007.