| NPI | 1922798099 |
|---|---|
| Former Name | AMY STACY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.186625) |
| Enumeration Date | 2023-05-11 |
| Last Update Date | 2025-12-15 |