Individual
DAVID RAY STACKHOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
76 BROADWAY, DENVILLE, NJ 07834-2764
(973) 886-9701
Mailing address
76 BROADWAY, DENVILLE, NJ 07834-2764
(973) 886-9701
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC00844700
NJ
Other
Enumeration date
12/13/2006
Last updated
12/27/2017
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