| Doctor Name: | ROBERT E ENNIS |
| NPI Number: | 1063793594 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMSW |
| License Number: | 6801010482 |
| Business Practice Address: | 129 E 3rd St Flint, MI - 485021728 |
| Business Phone Number: | 8102334031 |
| Business Fax Number: | 8102374141 |
| Mailing Address: | 12190 Silver Lake Rd, BYRON |
| State: | MI |
| Postal Code: | 484189001 |
| Phone Number: | 8102334031 |
| Fax Number: | 8102374141 |
| NPI Enumeration Date: | 08/29/2011 |
| NPI Last Update Date: | 08/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 6801010482 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |