Individual
KEVIN STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8449 COLONIAL ST, DEARBORN HEIGHTS, MI 48127-1304
(313) 909-0004
Mailing address
8449 COLONIAL ST, DEARBORN HEIGHTS, MI 48127-1304
(313) 909-0004
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
L738911
MI
Other
Enumeration date
01/25/2016
Last updated
01/25/2016
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