Individual
STACY GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPH, RN, BSN
Contact information
Practice address
1627 W BIG BEAVER RD, TROY, MI 48084-3501
(248) 563-2920
Mailing address
PO BOX 250042, WEST BLOOMFIELD, MI 48325-0042
(248) 563-2920
(248) 862-2022
Taxonomy
Speciality
Code
Description
License number
State
163WN1003X
Nutrition Support Registered Nurse
Primary
4704212928
MI
Other
Enumeration date
12/09/2009
Last updated
12/09/2009
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