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Individual

DAVID WALLACE STOEPKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSY.D.

Contact information

Practice address
1530 NICHOLS RD, KALAMAZOO, MI 49006-2065
(269) 343-6700
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301002040
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OC94548
BC/BS #
MI
Enumeration date
07/29/2006
Last updated
03/30/2015
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