Individual
STACY MAIJALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 POPLAR ST, HANCOCK, MI 49930-1121
(906) 482-6644
Mailing address
PO BOX 94, PAINESDALE, MI 49955-0094
(906) 370-2142
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101004992
MI
Other
Enumeration date
11/26/2015
Last updated
11/26/2015
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