Individual
STACY KRUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDAC
Contact information
Practice address
151 MARION BLVD, MARION, IA 52302-3135
(319) 363-2878
(319) 364-2159
Mailing address
1190 MAPLECREST DR, MARION, IA 52302-2141
(319) 651-8118
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19040
IA
Other
Enumeration date
07/18/2019
Last updated
07/18/2019
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