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Individual

CONNIE STACY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MED

Contact information

Practice address
1203 AMERICAN GREETING CARD RD, CORBIN, KY 40701-4811
(606) 528-7010
Mailing address
PO BOX 568, CORBIN, KY 40702-0568

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPCA 1092
KY

Other

Enumeration date
07/30/2010
Last updated
07/30/2010
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