Provider Demographics
NPI:1841019924
Name:WINGATE-FRIERSON, SHIRLEY (LLPC)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:WINGATE-FRIERSON
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8765 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPERANCE
Mailing Address - State:MI
Mailing Address - Zip Code:48182-9300
Mailing Address - Country:US
Mailing Address - Phone:734-654-2169
Mailing Address - Fax:734-850-0520
Practice Address - Street 1:8765 LEWIS AVE
Practice Address - Street 2:
Practice Address - City:TEMPERANCE
Practice Address - State:MI
Practice Address - Zip Code:48182-9300
Practice Address - Country:US
Practice Address - Phone:734-654-2169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool