Provider Information for 1477898385
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Mr. STEPHEN C ROEGGE LMSW
Sex: Male
NPI: 1477898385
Last Updated: 2013-01-11
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1477898385 | ||||||||
| Enumeration Date | 2012-12-04 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 31 LOWELL NE GRAND RAPIDS, MI 49503 United States Phone: 616-450-0656 | Fax: | ||||||||
| Primary Practice Address | 2020 RAYBROOK SE SUITE 306 GRAND RAPIDS, MI 49546 United States Phone: 616-450-0656 | Fax: | ||||||||
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