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Individual
STACY ERTLE
Active
Individual
STACY ERTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPCC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11798371
CAQH
—
01
—
NM000105
VALUE OPTIONS OF NM #
NM
Enumeration date
08/30/2006
Last updated
06/15/2010
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