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Individual
STACIA ANN SHIRLEY
Active
Individual
STACIA ANN SHIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.173892
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.177613
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0407485
—
OH
Enumeration date
06/19/2020
Last updated
06/06/2023
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