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Individual
SANTANA RAE STAUTY
Active
Individual
SANTANA RAE STAUTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC MS CRC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100079838
—
WI
Enumeration date
12/18/2017
Last updated
08/06/2020
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