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Individual

MS. STACY MARIE BRAULT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BSW

Contact information

Practice address
8021 CLEAR HAVEN CIR, ANCHORAGE, AK 99507-3272
(907) 349-8157
(907) 222-1336
Mailing address
PO BOX 231724, ANCHORAGE, AK 99523-1724
(907) 349-8157
(907) 222-1336

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
746362
AK
251B00000X
Case Management Agency
746362
AK

Other

Enumeration date
12/19/2007
Last updated
08/20/2008
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