| NPI | 1366869232 |
|---|---|
| Former Name | STACY MICHELLE KIRK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 6702) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2025-01-03 |