Individual
JERRI LYNN STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2545 SW M ST, RICHMOND, IN 47374
(765) 969-9777
Mailing address
PO BOX 487, RICHMOND, IN 47375-0487
(765) 983-8000
(765) 983-8609
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.162275
OH
101YM0800X
Mental Health Counselor
Primary
S.2207800
OH
Other
Enumeration date
10/18/2006
Last updated
06/19/2024
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