Doctor Name: | STACIE ADAMS |
NPI Number: | 1891156618 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, EDS, LPCA |
License Number: | A11955 |
Business Practice Address: | 105 Open Meadow Dr Dobson, NC - 270178662 |
Business Phone Number: | 3364042986 |
Business Fax Number: | |
Mailing Address: | 105 Open Meadow Dr, DOBSON |
State: | NC |
Postal Code: | 270178662 |
Phone Number: | 3364042986 |
Fax Number: | |
NPI Enumeration Date: | 03/08/2016 |
NPI Last Update Date: | 03/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | A11955 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |