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Individual

DR. STACEY ROCHELLE LIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D.

Contact information

Practice address
1101 HEALTH PROFESSIONS BLDG, MT PLEASANT, MI 48859-0001
(989) 774-3904
(989) 774-1891
Mailing address
1101 HEALTH PROFESSIONS BLDG, MT PLEASANT, MI 48859-0001
(989) 774-3904
(989) 774-1891

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000660
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1601000660
STATE LICENSE
MI
01
170008414
NPI
MI
01
1700084142
NPI
MI
Enumeration date
07/06/2007
Last updated
01/13/2014
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