Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 6401011783 | MI |
N | 101YS0200X | School Counselor | IF0000000187310 | MI |
NPI | 1235428202 |
---|---|
Provider Name | Stephanie Marie Bigelow |
First Address | Livonia, MI 48152-2891 |
Second Address | Livonia, MI 48152-2891 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2011 |
Last Update Date | 15/03/2017 |