Doctor Name: | STACY A SAVAGE |
NPI Number: | 1053575530 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | MH8612 |
Business Practice Address: | 381 Palm Coast Pkwy Sw Palm Coast, FL - 321374781 |
Business Phone Number: | 3865972904 |
Business Fax Number: | 3865972903 |
Mailing Address: | 78 Freemont Turn, PALM COAST |
State: | FL |
Postal Code: | 321374782 |
Phone Number: | 3865972904 |
Fax Number: | 3865972903 |
NPI Enumeration Date: | 07/15/2008 |
NPI Last Update Date: | 07/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH8612 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |