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Individual

STACIE SANTOYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PPC

Contact information

Practice address
389 ADAMS STREET, AFTON, WY 83110-0376
(307) 885-9883
(307) 885-5206
Mailing address
PO BOX 376, AFTON, WY 83110-0376
(307) 885-9883
(307) 885-5206

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PPC-585
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1457472748
WY
Enumeration date
07/19/2011
Last updated
07/19/2011
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