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General NPI Number Information
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NPI Number | 1083744460
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Entity Type | Individual
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Provider Name | PAMELA ELLEN STOLZ LMSW
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 26650 EUREKA RD ST. A
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City | TAYLOR
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State | MI
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Zip | 48180-4835
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Country | US
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Telephone | 734-955-3550
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Fax | 734-955-3652
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Provider Business Mailing Address
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Address Line | 43561 BANNOCKBURN DR
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City | CANTON
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State | MI
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Zip | 48187-2819
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Country | US
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Telephone | 734-455-7409
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801034475
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License Number State | MI
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