| Doctor Name: | MS. KRISTI LUCILLE STUCKWISCH |
| NPI Number: | 1396152344 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW, LISAC |
| License Number: | LISAC-10333 |
| Business Practice Address: | 483 W. Seed Farm Rd. Sacaton, AZ - 851470038 |
| Business Phone Number: | 6025281200 |
| Business Fax Number: | 6025281255 |
| Mailing Address: | 13400 E Shea Blvd, SCOTTSDALE |
| State: | AZ |
| Postal Code: | 852595499 |
| Phone Number: | 4803018000 |
| Fax Number: | |
| NPI Enumeration Date: | 07/22/2014 |
| NPI Last Update Date: | 12/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | LISAC-10333 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |