Provider Demographics
NPI:1386195592
Name:BUTLER, ANDREW SHEHADEH
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:SHEHADEH
Last Name:BUTLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4909 TANAGER DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-9644
Mailing Address - Country:US
Mailing Address - Phone:734-770-7912
Mailing Address - Fax:
Practice Address - Street 1:4909 TANAGER DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-9644
Practice Address - Country:US
Practice Address - Phone:734-770-7912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker