Individual
STACY LEE DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1804 S EDDY ST, GRAND ISLAND, NE 68801-7114
(308) 663-3590
Mailing address
1804 S EDDY ST, GRAND ISLAND, NE 68801-7114
(308) 336-3590
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CPSS-329
NE
175T00000X
Peer Specialist
Primary
CPSS-329
NE
Other
Enumeration date
07/16/2024
Last updated
03/05/2026
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