Individual
MRS. MICHELLE E STILLWAGON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMFT
Contact information
Practice address
939 BAXTER AVE, 1ST FLOOR, LOUISVILLE, KY 40204-2046
(502) 417-9021
Mailing address
939 BAXTER AVE, 1ST FLOOR, LOUISVILLE, KY 40204-2046
(502) 417-9021
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0653
KY
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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