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General NPI Number Information
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NPI Number | 1932269263
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Entity Type | Individual
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Provider Name | MARY BETH STELMA PH.D.
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Gender | Female
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4660 MARSH RD
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City | OKEMOS
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State | MI
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Zip | 48864-2143
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Country | US
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Telephone | 517-347-6077
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Fax |
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Provider Business Mailing Address
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Address Line | 1720 CHIEF OKEMOS CIR
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City | OKEMOS
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State | MI
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Zip | 48864-2224
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Country | US
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Telephone | 517-381-1933
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301007534
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License Number State | MI
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