| NPI | 1992994727 |
|---|---|
| Other Name | STACYLEE ANN KNOBLACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME 3762) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2009-08-24 |