Organization
STACY REUILLE-DUPONT, LLC
Active
Organization
STACY REUILLE-DUPONT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA STOCKTON CCMA, BSHM (OFFICE MANAGER)
(970) 422-1761
Entity
Organization
Contact information
Practice address
1305 ESCALANTE DR # 203, DURANGO, CO 81303-8931
(970) 749-8227
Mailing address
1305 ESCALANTE DR # 203, DURANGO, CO 81303-8931
(970) 749-8227
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
4577
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49670379
—
CO
Enumeration date
04/17/2018
Last updated
07/23/2024
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