| NPI | 1144710773 |
|---|---|
| Former Name | STACY SHARON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801102852) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2020-12-21 |