Individual
TASHA ANDREA STANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4500 W MIDWAY RD, FORT PIERCE, FL 34981-4823
(772) 672-8466
Mailing address
2616 SW ACACIA AVE, PORT SAINT LUCIE, FL 34987-2209
(772) 323-7362
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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