Individual
MRS. STACEY KATHLEEN OSWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLPC
Contact information
Practice address
1240 NORTHLAWN ST NE, GRAND RAPIDS, MI 49505-3866
(616) 490-6471
Mailing address
1240 NORTHLAWN ST NE, GRAND RAPIDS, MI 49505-3866
(616) 490-6471
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401015581
MI
Other
Enumeration date
12/29/2016
Last updated
12/29/2016
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