Individual
STACI WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
100 ESSEX CT, MADISON, AL 35758-3139
(256) 325-2388
Mailing address
4300 S HARVARD AVE, TULSA, OK 74135-2619
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
06/18/2010
Last updated
01/30/2019
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