Individual
STACY MICHELLE WIESE-BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28 CONNORS WAY, SOMERSET, KY 45203
(606) 875-5942
Mailing address
28 CONNORS WAY, SOMERSET, KY 45203
(606) 875-5942
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
12/28/2009
Last updated
05/12/2014
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