Individual
STACY LEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-CP
Contact information
Practice address
77 HAZZARD CREEK VLG, RIDGELAND, SC 29936-8266
(843) 645-7700
Mailing address
77 HAZZARD CREEK VLG, RIDGELAND, SC 29936-8266
(443) 235-6161
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11801
SC
Other
Enumeration date
05/07/2021
Last updated
05/07/2021
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