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Individual

STACIE SANDALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
110 E E ST, MC COOK, NE 69001-2049
(308) 340-1165
Mailing address
807 NORRIS AVE, MC COOK, NE 69001-3144
(308) 340-1165

Taxonomy

Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
54739511
NE

Other

Enumeration date
12/27/2024
Last updated
12/27/2024
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