Individual
STACEY DEANN CRUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PASTORAL COUNSELOR
Contact information
Practice address
71 CAVALIER BLVD #303, FLORANCE, KY 41042
(859) 282-0204
(859) 282-0361
Mailing address
71 CAVALIER BLVD #303, FLORANCE, KY 41042
(859) 282-0204
(859) 282-0361
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
263317
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100627070
—
KY
Enumeration date
07/23/2020
Last updated
07/23/2020
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