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NPI Code Detail

MEDICARE: STEPHANIE NOBACH

MEDICARE: STEPHANIE NOBACH
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
11041C0700XClinical Social Worker6801120210MI

General Provider Information

NPI Number : 1881122075
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE NOBACH
Provider Business Mailing Address
First Line : 5325 SEQUOIA CT
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-3502
Country : US
Telephone Number : 810-295-6829
Fax Number :
Provider Business Practice Location Address
First Line : 5325 SEQUOIA CT
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-3502
Country : US
Telephone Number : 810-295-6829
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2017
Last Update Date : 01/22/2026

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Directions to “ STEPHANIE NOBACH ” Practice Location

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