| NPI | 1063664332 |
|---|---|
| Former Name | STACIA ALISE RICHARDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.1600093) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH 1600093) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-10-18 |
| Last Update Date | 2019-04-03 |