Individual
STACY SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAP STUDENT
Contact information
Practice address
1633 W. MAIN ST, LEBANON, TN 37087
(850) 331-8681
Mailing address
4908 BELL RIDGE LANE APRTMENT 104, MILTON, FL 32571
(850) 713-4609
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/23/2020
Last updated
11/24/2020
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