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1720590516
STACELYNNE MACK
FARMINGTON HILLS, MI
NPI
1720590516
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Former Name
STACELYNNE WALLACE
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041S0200X Social Worker, School
(Licence: MI 6801082564)
Enumeration Date
2017-11-02
Last Update Date
2017-11-02
Business Address
STACELYNNE MACK LMSW
30601 CREST FRST
FARMINGTON HILLS, MI 48331-1052
Phone number: 248-506-4065
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Mailing Address
STACELYNNE MACK LMSW
PO BOX 47505
OAK PARK, MI 48237-5205
Phone number: 248-506-4065
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