Individual
STACY ANN PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9083 MENTOR AVE, MENTOR, OH 44060-6462
(216) 409-5261
Mailing address
430 INDEPENDENCE ST, FAIRPORT HARBOR, OH 44077-5640
(216) 409-5261
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
APS.006463
OH
Other
Enumeration date
07/30/2025
Last updated
07/30/2025
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