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Individual

STACEY MARTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
530 GRANT ST, WAUSAU, WI 54403-4738
(715) 845-5493
Mailing address
229059 CHICKEN LN, MARATHON, WI 54448-2406
(715) 803-3258

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
WI
101YM0800X
Mental Health Counselor

Other

Enumeration date
02/27/2023
Last updated
03/07/2023
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