| Doctor Name: | STACY R ESPINOZA |
| NPI Number: | 1053749598 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC/CR |
| License Number: | C.1200290 |
| Business Practice Address: | 300 W National Rd Vandalia, OH - 453771928 |
| Business Phone Number: | 9372802000 |
| Business Fax Number: | |
| Mailing Address: | 300 W National Rd, VANDALIA |
| State: | OH |
| Postal Code: | 453771928 |
| Phone Number: | 9372802000 |
| Fax Number: | |
| NPI Enumeration Date: | 10/18/2013 |
| NPI Last Update Date: | 10/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | C.1200290 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |