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Individual

MRS. STACY MARSHALL DAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MACC, LPC

Contact information

Practice address
250 DEWEY AVE, SPARTANBURG, SC 29303-3009
(864) 585-0366
(864) 583-3136
Mailing address
400 LAKE FOREST DR, SPARTANBURG, SC 29307-3739
(864) 706-7555

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7475
SC
171M00000X
Case Manager/Care Coordinator

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
121328
SC
Enumeration date
11/03/2009
Last updated
07/01/2020
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