Individual
CHRISTINE F STACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2106 IRONWOOD CIR, SOUTH BEND, IN 46635-1864
(574) 243-9370
(574) 243-9375
Mailing address
2106 IRONWOOD CIR, SOUTH BEND, IN 46635-1864
(574) 243-9370
(574) 243-9375
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004960A
—
Other
Enumeration date
10/13/2005
Last updated
04/18/2008
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