Individual
ANNEMARIE STACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9905 FALL CREEK RD, INDIANAPOLIS, IN 46256-4804
(317) 813-4690
Mailing address
2418 ROSEWOOD AVE, PORTAGE, MI 49024-1123
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/12/2023
Last updated
12/12/2023
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