Individual
STACEY LYNN PORRECA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1547 S WAYNE RD, WESTLAND, MI 48186-5436
(734) 405-0176
Mailing address
1547 S WAYNE RD, WESTLAND, MI 48181
(734) 405-0176
(734) 404-0184
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6801068161
MI
101YM0800X
Mental Health Counselor
6801068161
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
383501869
APEX BEHAVIORAL HEALTH TAX ID
MI
01
—
6801068161
APEX BEHAVIORAL HEALTH TAX ID
MI
Enumeration date
06/12/2008
Last updated
06/12/2008
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