Individual
JESSICA MARIE STAVALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
1135 W UNIVERSITY DR STE 445, ROCHESTER, MI 48307-1897
(248) 413-5077
Mailing address
1144 LONG MEADOWS CT, OXFORD, MI 48371-6052
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6362009562
MI
Other
Enumeration date
07/26/2022
Last updated
07/26/2022
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