Individual
STACIE PARKS STORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
53 WINDSOR CT, EDISTO ISLAND, SC 29438-3615
(843) 345-4445
Mailing address
53 WINDSOR CT, EDISTO ISLAND, SC 29438-3615
(843) 345-4445
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4428
SC
Other
Enumeration date
01/19/2022
Last updated
01/19/2022
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