| NPI | 1639617855 |
|---|---|
| Former Name | STACY M. YOUNG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 9109-123) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 130509-121) |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2019-03-27 |