Individual
STACY R DESMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1364 WHITE PINE DR, CLOQUET, MN 55720-7511
(218) 591-7375
Mailing address
1364 WHITE PINE DR, CLOQUET, MN 55720-7511
(218) 591-7375
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
02095
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84-4812831
PROFESSIONAL CLINICAL COUNSELING
MN
Enumeration date
12/08/2022
Last updated
12/08/2022
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