Individual
KIMBERLY LYNN STACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED. SP. ED.
Contact information
Practice address
11 DUNKLE CT, TANEYTOWN, MD 21787-2317
(315) 877-6937
Mailing address
11 DUNKLE CT, TANEYTOWN, MD 21787-2317
(315) 877-6937
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
3889
MD
Other
Enumeration date
06/13/2019
Last updated
06/13/2019
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