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NPI Code Detail

MEDICARE: JOURNEY NICOLE STOCKTON

MEDICARE: JOURNEY NICOLE STOCKTON
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1740958347
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOURNEY NICOLE STOCKTON
Provider Business Mailing Address
First Line : 9315 TELEGRAPH RD
Second Line :
City : REDFORD
State : MI
Zip : 48239-1260
Country : US
Telephone Number : 313-450-4500
Fax Number :
Provider Business Practice Location Address
First Line : 450 PEARL ST STE 3
Second Line :
City : STOUGHTON
State : MA
Zip : 02072-1617
Country : US
Telephone Number : 781-334-0057
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2021
Last Update Date : 07/07/2022

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Directions to “ JOURNEY NICOLE STOCKTON ” Practice Location

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