Individual
CAILLIE DIANNE STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2601 ELECTRIC AVE, PORT HURON, MI 48060-6587
(810) 216-1372
Mailing address
3992 OIL SPRINGS LINE, OIL SPRINGS, ONTARIO N0N1P-0
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306227764
—
MI
Enumeration date
01/09/2019
Last updated
01/09/2019
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