MR. Ty William Denver Stafford, BA
NPI #1194852426 in Gautier, Mississippi
Provider Information
- NPI Number
- 1194852426
- Entity Type
- Individual
- Name
- MR. Ty William Denver Stafford, BA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Case Manager/Care Coordinator
- Credential
- BA
- Enumeration Date
- Feb 27, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 3407 SHAMROCK CT
- City
- Gautier
- State
- Mississippi
- ZIP Code
- 39553
- Phone
- (228) 497-0690
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Manager/Care Coordinator |
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