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Individual

KATIE STEVENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AUD

Contact information

Practice address
2454 MONROE ST STE A, DEARBORN, MI 48124-3038
(313) 562-4100
Mailing address
2454 MONROE ST STE A, DEARBORN, MI 48124-3038
(313) 562-4100

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1601000840
LICENSE
MI
Enumeration date
06/12/2019
Last updated
06/12/2019
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