Doctor Name: | MISTY SCHAFFER |
NPI Number: | 1104299841 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 4704296436 |
Business Practice Address: | 1219 S Vassar Rd Davison, MI - 484238312 |
Business Phone Number: | 2482768013 |
Business Fax Number: | |
Mailing Address: | 1219 S Vassar Rd, DAVISON |
State: | MI |
Postal Code: | 484238312 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/03/2015 |
NPI Last Update Date: | 11/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | 4704296436 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |