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General NPI Number Information
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NPI Number | 1114582921
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Entity Type | Organization
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Legal Business Name | STABLE POSSIBILITIES LLC
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Dates
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Enumeration Date | 05/07/2019
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Last Update Date | 05/07/2019
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Provider Practice Location Address
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Address Line | 27751 24 MILE RD
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City | CHESTERFIELD
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State | MI
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Zip | 48051-1602
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Country | US
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Telephone | 586-292-8472
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Fax |
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Provider Business Mailing Address
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Address Line | 7081 FINNEGAN RD
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City | JOHANNESBURG
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State | MI
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Zip | 49751-9705
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Country | US
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Telephone | 586-946-0126
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Fax |
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Authorized Official
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Title or Position | BILLER
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Name | MARIA MOORE
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Credential |
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Telephone | 586-946-0126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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