Individual
STACIE RAE DAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW/LICSW/LAC
Contact information
Practice address
1237 W DIVIDE AVE, STE 5, BISMARCK, ND 58501-1220
(701) 328-8888
(701) 328-8900
Mailing address
1237 W DIVIDE AVE, STE 5, BISMARCK, ND 58501-1220
(701) 328-8888
(701) 328-8900
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1690
ND
1041C0700X
Clinical Social Worker
4736
ND
Other
Enumeration date
11/15/2007
Last updated
11/21/2012
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