| NPI | 1942370911 |
|---|---|
| Former Name | STACEY LYNN CROSCUT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WV 2072) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY P54457) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2016-07-21 |