| Shine Wellness Clinic, Pllc | |
|
1 N Starkweather Aly Fl 3 Romeo MI 48065-4690 | |
| (586) 281-6815 | |
| Not Available |
| Full Name | Shine Wellness Clinic, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 1 N Starkweather Aly Fl 3, Romeo, Michigan |
| Authorized Official Name and Position | Naomi Baba (OWNER) |
| Authorized Official Contact | 8105315333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shine Wellness Clinic, Pllc 1 N Starkweather Aly Fl 3 Romeo MI 48065-4690 Ph: () - | Shine Wellness Clinic, Pllc 1 N Starkweather Aly Fl 3 Romeo MI 48065-4690 Ph: (586) 281-6815 |
| NPI Number | 1952822587 |
|---|---|
| Provider Enumeration Date | 07/05/2017 |
| Last Update Date | 07/05/2017 |
| Medicare PECOS PAC ID | 3476825043 |
|---|---|
| Medicare Enrollment ID | O20170816002293 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952822587 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 6801091649 (Michigan) | Primary |
| Provider Name | Naomi M Page |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174815518 PECOS PAC ID: 4082887542 Enrollment ID: I20111027000572 |
| Provider Name | Stephanie K Evans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790835528 PECOS PAC ID: 2668762469 Enrollment ID: I20160607002054 |
| Provider Name | Linda D Howard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306958053 PECOS PAC ID: 2365793460 Enrollment ID: I20181001000574 |
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