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1194847749
SHELBY QUALLS
DETROIT, MI
NPI
1194847749
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MI 820080)
Enumeration Date
2007-04-04
Last Update Date
2007-07-08
Business Address
Mr. SHELBY QUALLS CAC-1
8809 JOHN C LODGE
DETROIT, MI 48224
Phone number: 313-887-6737
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Mailing Address
Mr. SHELBY QUALLS CAC-1
10520 MORANG DR
DETROIT, MI 48224-1840
Phone number: 313-640-8084
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