| NPI | 1437874963 |
|---|---|
| Former Name | STACY LYNN FEDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 114337) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA 114337) |
| Enumeration Date | 2022-10-06 |
| Last Update Date | 2023-07-18 |