Individual
SANDRA STASKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LPC
Contact information
Practice address
12265 JAMES ST, HOLLAND, MI 49424-8613
(616) 494-5600
Mailing address
13246 84TH AVE, COOPERSVILLE, MI 49404-9733
(720) 935-1187
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401014082
MI
Other
Enumeration date
02/11/2014
Last updated
10/14/2022
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