Organization Name: | ACTUALIZED CLINICAL SERVICES CONSULTING, INC. |
NPI Number: | 1205050903 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANGELA CHRISTINA STANLEY (OWNER & PRESIDENT) |
Mailing Address: | 820 Brinsmere Drive Elm Grove |
State: | WI US |
Postal Code: | 53122 |
Phone Number: | 2629935427 |
Fax Number: | |
NPI Enumeration Date: | 04/12/2007 |
NPI Last Update Date: | 01/09/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 930 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |