| NPI | 1659608115 |
|---|---|
| Former Name | STACY JEAN NIELSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L6376) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2023-11-27 |