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1043482854
STACEY LYNN TISSUE
PORT HURON, MI
NPI
1043482854
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
(Licence: MI 6802086138)
Enumeration Date
2008-04-01
Last Update Date
2008-04-01
Business Address
-- STACEY LYNN TISSUE LLBSW
2875 HENRY ST
PORT HURON, MI 48060-2526
Phone number: 810-987-9700
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Mailing Address
-- STACEY LYNN TISSUE LLBSW
4090 WELLMAN LINE RD
JEDDO, MI 48032-8105
Phone number:
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