Doctor Name: | STACY GATZ |
NPI Number: | 1730462433 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LLP, CCSOTS |
License Number: | 6301011660 |
Business Practice Address: | 501 Union St Eaton Rapids, MI - 488271368 |
Business Phone Number: | 5172502552 |
Business Fax Number: | |
Mailing Address: | 915 N Monroe St, ALBION |
State: | MI |
Postal Code: | 492241352 |
Phone Number: | 2694491759 |
Fax Number: | |
NPI Enumeration Date: | 09/20/2011 |
NPI Last Update Date: | 09/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TB0200X |
License Number: | 6301011660 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Cognitive & Behavioral |
Taxonomy Definition: |