| Doctor Name: | MR. TOMMY SOGBAFAI STEVENS |
| NPI Number: | 1013960301 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | TS039213 |
| Business Practice Address: | 2298 S Center Rd Burton, MI - 485191166 |
| Business Phone Number: | 8107422544 |
| Business Fax Number: | 8107422566 |
| Mailing Address: | 2298 S Center Rd, BURTON |
| State: | MI |
| Postal Code: | 485191166 |
| Phone Number: | 8107422544 |
| Fax Number: | 8107422566 |
| NPI Enumeration Date: | 05/18/2006 |
| NPI Last Update Date: | 01/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TF0000X |
| License Number: | TS039213 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |