Provider Demographics
NPI:1124576459
Name:APOSTOLOS-STOWELL, VASILIKIH
Entity Type:Individual
Prefix:
First Name:VASILIKIH
Middle Name:
Last Name:APOSTOLOS-STOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 S PENNSYLVANIA AVE
Mailing Address - Street 2:FOOD & NUTRITION
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-3488
Mailing Address - Country:US
Mailing Address - Phone:517-975-2217
Mailing Address - Fax:517-975-2210
Practice Address - Street 1:2727 S PENNSYLVANIA AVE
Practice Address - Street 2:FOOD & NUTRITION
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-3488
Practice Address - Country:US
Practice Address - Phone:517-975-2217
Practice Address - Fax:517-975-2210
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI853688133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered