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Individual
STACEY NICOLE BISHOFSKY
Active
Individual
STACEY NICOLE BISHOFSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
127698-121
WI
104100000X
Social Worker
19606
MN
1041C0700X
Clinical Social Worker
Primary
19606
MN
Other
Enumeration date
10/23/2009
Last updated
05/25/2023
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