Basic Information
| Provider Information | |||||||||
| NPI: | 1144627480 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOZNIAK | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | ANNA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 888 W BIG BEAVER RD | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480844736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482448644 | ||||||||
| FaxNumber: | 2482441330 | ||||||||
| Practice Location | |||||||||
| Address1: | 888 W BIG BEAVER RD | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480844736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2482448644 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2014 | ||||||||
| LastUpdateDate: | 03/04/2019 | ||||||||
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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 | 1041C0700X | 6801091308 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.