Provider Demographics
NPI:1548516883
Name:STROMBERGER, STEPHANIE (MS)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:STROMBERGER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:SAFFLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23764 REYNOLDS AVE
Mailing Address - Street 2:
Mailing Address - City:HAZEL PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48030-1449
Mailing Address - Country:US
Mailing Address - Phone:313-444-5342
Mailing Address - Fax:
Practice Address - Street 1:8623 N WAYNE RD STE 123
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185
Practice Address - Country:US
Practice Address - Phone:734-367-0469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012983101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor