Individual
ANDERS ROSS-BRANDT STAKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3809 LAKE EASTBROOK BLVD SE, GRAND RAPIDS, MI 49546-5931
(616) 604-8492
(616) 604-8493
Mailing address
3809 LAKE EASTBROOK BLVD SE, GRAND RAPIDS, MI 49546-5931
(616) 604-8492
(616) 604-8493
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/19/2023
Last updated
12/19/2023
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