Individual
SOPHIA STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CP60312841
Contact information
Practice address
4800 COLLEGE ST SE, LACEY, WA 98503-4389
(360) 493-5045
Mailing address
4800 COLLEGE ST SE, LACEY, WA 98503-4389
(360) 493-5045
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60312841
WA
Other
Enumeration date
03/27/2017
Last updated
03/27/2017
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