Individual
PAMELA JEAN STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, RN
Contact information
Practice address
720 N MARR RD, COLUMBUS, IN 47201-6660
(812) 314-3400
(812) 376-4875
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
(812) 337-2438
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006033A
IN
163W00000X
Registered Nurse
28142163A
OH
Other
Enumeration date
03/08/2006
Last updated
04/28/2016
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