Doctor Name: | ANNE STACY |
NPI Number: | 1063476927 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 49852193501 |
Business Practice Address: | 575 East 100 South Price, UT - 84501 |
Business Phone Number: | 4356372358 |
Business Fax Number: | 4356379141 |
Mailing Address: | Po Box 867, 105 West 100 North PRICE |
State: | UT |
Postal Code: | 84501 |
Phone Number: | 4356377200 |
Fax Number: | 4356372377 |
NPI Enumeration Date: | 04/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 49852193501 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |