Individual
MRS. STACIE CHAMPEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12795 FOUNTAIN SQ, DAVISBURG, MI 48350-9991
(248) 250-0140
Mailing address
12795 FOUNTAIN SQ, DAVISBURG, MI 48350-9991
(248) 250-0140
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401014143
MI
Other
Enumeration date
06/06/2014
Last updated
10/06/2014
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