| NPI | 1114268869 |
|---|---|
| Former Name | STACEY CRAIG RIBERDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C011946) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 118878) |
| Enumeration Date | 2013-03-05 |
| Last Update Date | 2022-12-29 |