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General NPI Number Information
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NPI Number | 1528864840
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Entity Type | Individual
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Provider Name | STACIA D WARD LLMSW
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Gender | Female
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 1014 COLLEGE AVE
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City | HOUGHTON
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State | MI
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Zip | 49931-1823
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Country | US
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Telephone | 906-523-7064
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 513
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City | SOUTH RANGE
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State | MI
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Zip | 49963-0513
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Country | US
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Telephone | 906-379-5271
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6851119494
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License Number State | MI
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