Individual
SHAWNA STUCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW L8462
Contact information
Practice address
8495 CRATER LAKE HWY, WHITE CITY, OR 97503-3011
(541) 826-2111
Mailing address
1654 NE FOOTHILL BLVD APT B, GRANTS PASS, OR 97526-4237
(541) 826-2111
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L8462
OR
Other
Enumeration date
05/21/2020
Last updated
05/21/2020
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