Individual
DIANE STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18609 W 7 MILE RD, DETROIT, MI 48219-2702
(313) 532-8015
(313) 532-2773
Mailing address
12367 NORTHLAWN ST, DETROIT, MI 48204-1019
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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