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Individual
MS. STACIE ELLEN COTTRELL
Active
Individual
MS. STACIE ELLEN COTTRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10875612-3501
UT
1041S0200X
School Social Worker
10875612-3501
UT
167G00000X
Licensed Psychiatric Technician
—
—
Other
Enumeration date
07/09/2013
Last updated
06/07/2022
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