| NPI | 1710622675 |
|---|---|
| Doing Business As | ANGELA STATHOPOULOS |
| Entity Type | Organization |
| Authorized Contact | JESSICA MARIA CAMPOS Office Manager 517-347-4848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2022-05-04 |