| NPI | 1114104098 |
|---|---|
| Former Name | STACY LYNN MAYNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34005864A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 255048) |
| 1041C0700X Social Worker, Clinical (Licence: OR l13060) | |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2022-04-27 |