Individual
STEPHANIE MARIA STACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 S MILWAUKEE ST, THERESA, WI 53091-9785
(920) 638-7753
Mailing address
500 S MILWAUKEE ST, THERESA, WI 53091-9785
(920) 638-7753
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
135831121
WI
Other
Enumeration date
10/30/2025
Last updated
10/30/2025
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