Individual
MS. TANYA STOVALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23330 OAK GLEN DR, SOUTHFIELD, MI 48033-3491
(877) 436-4636
(877) 436-4636
Mailing address
23330 OAK GLEN DR, SOUTHFIELD, MI 48033-3491
(877) 436-4636
(877) 436-4636
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
—
—
291U00000X
Clinical Medical Laboratory
Primary
23D2176188
MI
Other
Enumeration date
01/23/2017
Last updated
01/20/2020
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