Individual
STACY PRINCE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
240 W TYRONE RD, OAK RIDGE, TN 37830-6517
(865) 482-1076
(865) 481-6179
Mailing address
240 W TYRONE RD, OAK RIDGE, TN 37830-6517
(865) 482-1076
(865) 481-6179
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1219
TN
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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