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1316076110
DIANE STAFFORD
DETROIT, MI
NPI
1316076110
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-03-05
Last Update Date
2007-07-08
Business Address
-- DIANE STAFFORD
18609 W 7 MILE RD
DETROIT, MI 48219-2702
Phone number: 313-532-8015
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Mailing Address
-- DIANE STAFFORD
12367 NORTHLAWN ST
DETROIT, MI 48204-1019
Phone number:
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