STACELYNNE MACK

FARMINGTON HILLS, MI
NPI1720590516
Former NameSTACELYNNE WALLACE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041S0200X Social Worker, School
(Licence: MI  6801082564)
Enumeration Date2017-11-02
Last Update Date2017-11-02
Business Address
STACELYNNE MACK LMSW
30601 CREST FRST
FARMINGTON HILLS, MI 48331-1052
Phone number: 248-506-4065
Mailing Address
STACELYNNE MACK LMSW
PO BOX 47505
OAK PARK, MI 48237-5205
Phone number: 248-506-4065