| NPI | 1104000769 |
|---|---|
| Former Name | STACY FYE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN 3299) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional (Licence: MS 1407) | |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2024-05-06 |