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Individual
MR. STACEY GLENN STOCKING
Active
Individual
MR. STACEY GLENN STOCKING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMHC, ASUDC, TRS
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
108034-6008
UT
101YM0800X
Mental Health Counselor
Primary
108034-6004
UT
225800000X
Recreation Therapist
108034-4002
UT
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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