Individual
STACEY DIEMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
775 36TH ST SE, GRAND RAPIDS, MI 49548-2319
(616) 248-5156
Mailing address
PO BOX 141, GRAND RAPIDS, MI 49501-0141
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/22/2016
Last updated
07/22/2016
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