| NPI | 1528314523 |
|---|---|
| Former Name | STACEY SIERACZYNSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801106088) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801106088) |
| 1041C0700X Social Worker, Clinical (Licence: MI 6801094345) | |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2023-05-18 |