Individual
MR. NATHAN W STALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA LPC
Contact information
Practice address
819 MAIN ST, PARKVILLE, MO 64152-3630
(816) 607-1713
Mailing address
819 MAIN ST, PARKVILLE, MO 64152-3630
(816) 607-1713
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2016001689
MO
Other
Enumeration date
02/16/2016
Last updated
04/15/2021
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