Individual
STACEY LAQUITA MARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1321 MCMILLAN AVE, BREWTON, AL 36426-1324
(251) 867-3242
Mailing address
5929 PINEYWOODS PL, APT # 26, MILTON, FL 32570-5094
(334) 507-1005
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/15/2010
Last updated
10/22/2010
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