Provider Demographics
NPI:1619206521
Name:STRESS RELIEF MANAGEMENT
Entity Type:Organization
Organization Name:STRESS RELIEF MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:IZABELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORIVODSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-539-8781
Mailing Address - Street 1:30500 NORTHWESTERN HWY.,
Mailing Address - Street 2:#316B
Mailing Address - City:FARMIGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30500 NORTHWESTERN HWY.,
Practice Address - Street 2:#316B
Practice Address - City:FARMIGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334
Practice Address - Country:US
Practice Address - Phone:248-539-8781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801085997104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty