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Individual

STACIA JEAN EBELT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
20300 SUPERIOR RD, TAYLOR, MI 48180-6331
(734) 785-7700
Mailing address
12142 LAPEER RD, DAVISON, MI 48423-8119

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6362010045
MI

Other

Enumeration date
08/21/2023
Last updated
09/11/2024
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