Basic Information
| Provider Information | |||||||||
| NPI: | 1073643755 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STAJICH-TRIMMER | ||||||||
| FirstName: | CASSANDRA | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | STAJICH-TRIMMER | ||||||||
| OtherFirstName: | CASSIE | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | L.M.S.W., C.T.C. | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2006 HOGBACK RD STE 1 | ||||||||
| Address2: | |||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481059750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347862300 | ||||||||
| FaxNumber: | 7347864915 | ||||||||
| Practice Location | |||||||||
| Address1: | 2006 HOGBACK RD STE 1 | ||||||||
| Address2: | |||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481059750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7347862300 | ||||||||
| FaxNumber: | 7347864915 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2007 | ||||||||
| LastUpdateDate: | 03/19/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 6801077324 | MI | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.