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Individual

STACY S JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
2814 S US HIGHWAY 1 STE D4, FORT PIERCE, FL 34982-8110
(772) 489-4726
(772) 489-0423
Mailing address
2814 S US HIGHWAY 1 STE D4, FORT PIERCE, FL 34982-8110
(772) 489-4726
(772) 489-0423

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
05/14/2012
Last updated
05/14/2012
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