Provider Demographics
NPI:1255156337
Name:STANCLE, CHRISTINE EG (CBD, CLC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:EG
Last Name:STANCLE
Suffix:
Gender:F
Credentials:CBD, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1887 MAPLEVIEW ST SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-4960
Mailing Address - Country:US
Mailing Address - Phone:616-617-8115
Mailing Address - Fax:
Practice Address - Street 1:1887 MAPLEVIEW ST SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-4960
Practice Address - Country:US
Practice Address - Phone:616-617-8115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula