| NPI | 1376931287 |
|---|---|
| Former Name | STACY DRAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WV BP00944341) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WV BP00944341) |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2022-02-28 |