MEDICARE: STEPHANIE SCHUYLER ROSS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1568034494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE SCHUYLER ROSS

Provider Business Mailing Address
First Line	:	754 WOODLAWN AVE
Second Line	:
City	:	OWOSSO
State	:	MI
Zip	:	48867-4629
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1480 N M 52
Second Line	:
City	:	OWOSSO
State	:	MI
Zip	:	48867-1290
Country	:	US
Telephone Number	:	989-723-8239
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2021
Last Update Date	:	07/12/2021

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Directions to “ STEPHANIE SCHUYLER ROSS ” Practice Location

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