Individual
MS. KIMBERLY J STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
243 LAKEWOOD ST, DETROIT, MI 48215-3151
(313) 420-9537
Mailing address
28000 DEQUINDRE RD, WARREN, MI 48092-2468
(586) 753-0400
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401010739
MI
Other
Enumeration date
04/23/2008
Last updated
06/10/2015
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