| NPI | 1174877203 |
|---|---|
| Former Name | STACY L MCFANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.1000490-SUPV) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C1000490) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2018-03-20 |