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Individual

MRS. CYNTHIA LEE STOVALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
34323 WEBER RD, RICHMOND, MI 48062-3011
(810) 392-3757
Mailing address
34323 WEBER RD, RICHMOND, MI 48062-3011
(810) 392-3757

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
5202002631
MI
172V00000X
Community Health Worker
5202002631
MI

Other

Enumeration date
02/15/2009
Last updated
02/15/2009
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