Provider Demographics
NPI:1790747194
Name:STIRLING-DOHERTY, MARY ANN HILDA (MA LLP LBSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY ANN
Middle Name:HILDA
Last Name:STIRLING-DOHERTY
Suffix:
Gender:F
Credentials:MA LLP LBSW
Other - Prefix:MISS
Other - First Name:MARY ANN
Other - Middle Name:HILDA
Other - Last Name:STIRLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1860 MAYER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MI
Mailing Address - Zip Code:48063
Mailing Address - Country:US
Mailing Address - Phone:810-329-4248
Mailing Address - Fax:
Practice Address - Street 1:1322 N RIVER RD
Practice Address - Street 2:NORSERV GROUP LTD
Practice Address - City:ST CLAIR
Practice Address - State:MI
Practice Address - Zip Code:48079
Practice Address - Country:US
Practice Address - Phone:810-329-4798
Practice Address - Fax:810-329-7303
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301003297103TC0700X
MI68010198621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical