Individual
MS. STACY MOORE O'MARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.H.C.
Contact information
Practice address
661 SEMINOLA BLVD, CASSELBERRY, FL 32707-3057
(407) 405-0585
Mailing address
661 SEMINOLA BLVD, CASSELBERRY, FL 32707-3057
(407) 405-0585
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MH9094
FL
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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