Provider Information for 1194050872
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Mrs. VANESSA STAFFORD LMSW
Sex: Female
NPI: 1194050872
Last Updated: 2009-10-13
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1194050872 | ||||||||
| Enumeration Date | 2009-10-13 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 38086 LANTERN HILL CT FARMINGTON HILLS, MI 48331-2896 United States Phone: 248-848-7088 | Fax:248-848-9763 | ||||||||
| Primary Practice Address | 32231 SCHOOLCRAFT RD LIVONIA, MI 48150-4312 United States Phone: 734-266-6800 | Fax:734-266-6015 | ||||||||
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