| NPI | 1649733189 |
|---|---|
| Professional Name | STACEY KING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 7088-226) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 18842-130) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2022-09-13 |