Individual
DARCI STANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCCS
Contact information
Practice address
130 E VINE ST, OWATONNA, MN 55060-2428
(507) 414-7287
Mailing address
130 E VINE ST, OWATONNA, MN 55060-2428
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BCCS205744
MN
251300000X
Local Education Agency (LEA)
—
—
Other
Enumeration date
09/18/2017
Last updated
05/06/2020
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