| NPI | 1760671630 |
|---|---|
| Former Name | STACEY PASSIG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2007-10-17 |