Individual
BIANCA STACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
112 W CERVANTES ST, PENSACOLA, FL 32501-3128
(504) 930-8135
Mailing address
601 E BELMONT ST, PENSACOLA, FL 32501-4907
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
16644
FL
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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