Individual
MRS. STACY RENNE EPPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCDC CCJS CDP AT CAD
Contact information
Practice address
10559 S PROSPECT AVE, CHICAGO, IL 60643-2923
(773) 339-5746
(773) 238-3278
Mailing address
STACY RENNE EPPS DE STEFANO, 10559 SOUTH PROSPECT AVE, CHICAGO, IL 60643-2923
(773) 339-5746
(773) 238-3272
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
15175
IN
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15175
IN
Other
Enumeration date
08/07/2018
Last updated
08/07/2018
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