| NPI | 1497983753 |
|---|---|
| Former Name | STACY LYNN TEMPLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801090637) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6801090637) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2023-08-21 |