Individual
MRS. STACEY MICHELE BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHC
Contact information
Practice address
6801 SIOUX AVE, YUCCA VALLEY, CA 92284-2679
(760) 401-1568
Mailing address
6801 SIOUX AVE, YUCCA VALLEY, CA 92284-2679
(760) 401-1568
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
11/21/2022
Last updated
11/21/2022
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