Individual
MS. STACY MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3774 RIDGE PIKE, COLLEGEVILLE, PA 19426-3169
(610) 489-3340
(610) 489-3375
Mailing address
3774 RIDGE PIKE, COLLEGEVILLE, PA 19426-3169
(610) 489-3340
(610) 489-3375
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
117910
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100753390
—
PA
Enumeration date
06/12/2009
Last updated
06/12/2009
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