Individual
GABRIELLE JOAN STANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2870 MYSTIC VALLEY DR, WHITE LAKE, MI 48383-3292
(248) 464-3141
Mailing address
2870 MYSTIC VALLEY DR, WHITE LAKE, MI 48383-3292
(248) 464-3141
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601011851
MI
Other
Enumeration date
06/22/2022
Last updated
08/29/2024
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