Provider Demographics
NPI:1487776928
Name:SOBLASKEY, STEPHANIE JUNE (LMSW CSW)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:JUNE
Last Name:SOBLASKEY
Suffix:
Gender:F
Credentials:LMSW CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 MEDORA ST
Mailing Address - Street 2:
Mailing Address - City:SAINT IGNACE
Mailing Address - State:MI
Mailing Address - Zip Code:49781-1807
Mailing Address - Country:US
Mailing Address - Phone:906-643-0923
Mailing Address - Fax:
Practice Address - Street 1:135 BERTRAND ST
Practice Address - Street 2:
Practice Address - City:SAINT IGNACE
Practice Address - State:MI
Practice Address - Zip Code:49781-1705
Practice Address - Country:US
Practice Address - Phone:906-643-1592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010793261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical