Provider Demographics
NPI:1346490810
Name:SERGENT, STEPHANIE RENEE (BA/BSW)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:RENEE
Last Name:SERGENT
Suffix:
Gender:F
Credentials:BA/BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2811 E COURT ST. STUITE F
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48506
Mailing Address - Country:US
Mailing Address - Phone:810-232-6081
Mailing Address - Fax:810-232-6510
Practice Address - Street 1:2811 E COURT ST STE F
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48506-4054
Practice Address - Country:US
Practice Address - Phone:810-232-6081
Practice Address - Fax:810-232-6510
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical