Individual
STACY KNOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 CLEVELAND ST, GREENVILLE, SC 29607-2410
(864) 467-3790
Mailing address
1400 CLEVELAND ST, GREENVILLE, SC 29607-2410
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891795738
—
SC
Enumeration date
03/27/2018
Last updated
03/27/2018
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