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General NPI Number Information
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NPI Number | 1013219542
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Entity Type | Individual
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Provider Name | DEBORAH ANN STANLEY NCC
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Gender | Female
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Dates
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Enumeration Date | 12/04/2010
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Last Update Date | 12/04/2010
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Provider Practice Location Address
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Address Line | 36800 S GRATIOT AVE SUITE LL2
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48035-1773
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Country | US
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Telephone | 586-746-1428
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Fax |
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Provider Business Mailing Address
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Address Line | 20836 HALL RD #132
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-7227
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Country | US
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Telephone | 586-746-1428
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401011799
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License Number State | MI
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