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Individual

MATTHEW MICHAEL STANLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
548 BELL PRAIRIE CIR, LAKE WALES, FL 33859-2115
(312) 505-4798
Mailing address
548 BELL PRAIRIE CIR, LAKE WALES, FL 33859-2115
(312) 505-4798

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6401016859
MI

Other

Enumeration date
09/28/2018
Last updated
09/19/2024
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