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Individual

MRS. STACY MARIE YOUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
32652 KNO DRIVE, DOWAGIAC, MI 49047
(269) 982-3832
Mailing address
67160 DAILEY RD, EDWARDSBURG, MI 49112-9660
(269) 845-0069

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401016096
MI
101YP2500X
Professional Counselor
6401016096
MI
106H00000X
Marriage & Family Therapist
4101006741
MI

Other

Enumeration date
06/09/2017
Last updated
11/29/2023
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