| NPI | 1679906507 |
|---|---|
| Former Name | STACIE PAGE WELLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C5681) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 75987) |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2024-05-11 |