# STACEY EDWARDS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1992178784
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | 1-11-8617 | NULL | Yes |

## Other

- **Enumeration date:** 11/03/2015
- **Last updated:** 11/03/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1-11-8617 | BEHAVIOR ANALYST CERTIFICATION BOARD | — |
| 01 | — | BH001514 | PENNSYLVANIA DEPT OF STATE BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS | PA |