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1053904615
SHANNAN LUSTIG
LIVONIA, MI
NPI
1053904615
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: MI 6801116716)
Enumeration Date
2021-02-15
Last Update Date
2023-08-01
Business Address
SHANNAN LUSTIG
17177 N LAUREL PARK DR STE 131
LIVONIA, MI 48152-3952
Phone number: 734-462-3210
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Mailing Address
SHANNAN LUSTIG
17177 N LAUREL PARK DR STE 131
LIVONIA, MI 48152-3952
Phone number: 586-788-7471
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