Healthcare Provider Details

I. General information

NPI: 1538079520
Provider Name (Legal Business Name): JOSANA PAULA STICE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1454 N ROCHESTER RD
ROCHESTER HILLS MI
48307-1186
US

IV. Provider business mailing address

1454 N ROCHESTER RD APT 211
ROCHESTER HILLS MI
48307-1406
US

V. Phone/Fax

Practice location:
  • Phone: 248-379-5211
  • Fax:
Mailing address:
  • Phone: 248-379-5211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401007724
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: