| NPI | 1972742955 |
|---|---|
| Former Name | STACEY LEE ROSENQUEST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW016979) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW126947) |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2021-04-29 |