Organization
STIMAC STATHOPOULOS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY BETH HOUPT (CREDENTIALING)
(517) 676-9797
Entity
Organization
Contact information
Practice address
1410 TURNER ST, LANSING, MI 48906-4344
(517) 303-8044
Mailing address
PO BOX 10, MASON, MI 48854-0010
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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