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Individual
STACI LYNNE MACLEAN
Active
Individual
STACI LYNNE MACLEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
64432
CA
104100000X
Social Worker
91134
CA
1041C0700X
Clinical Social Worker
Primary
12602744-3501
UT
Other
Enumeration date
10/16/2017
Last updated
11/23/2022
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