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Individual
MR. CHARLES BENSON STACEY
Active
Individual
MR. CHARLES BENSON STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
4426
TX
106H00000X
Marriage & Family Therapist
Primary
CMF0068702
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84254289
—
NM
Enumeration date
05/23/2007
Last updated
02/29/2020
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