Individual
MRS. STACEY SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCDP, ICADC, MHS
Contact information
Practice address
505 W MARKET ST, SUITE 110, GEORGETOWN, DE 19947-2344
(302) 854-0626
Mailing address
30716 CYPRESS LN, LAUREL, DE 19956-3514
(302) 381-8483
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CD-0000082
DE
Other
Enumeration date
01/17/2017
Last updated
01/17/2017
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