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Individual
MRS. STACY M MCCANN
Active
Individual
MRS. STACY M MCCANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, BCBA, LBA
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
2013042874
MO
1041C0700X
Clinical Social Worker
Primary
149024521
IL
1041C0700X
Clinical Social Worker
2013033734
MO
Other
Enumeration date
10/12/2011
Last updated
01/06/2023
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