Individual
JACOB GARRETT STACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, CSAT
Contact information
Practice address
40 W CACHE VALLEY BLVD STE 10A, LOGAN, UT 84341-8450
(435) 787-2272
(435) 713-4001
Mailing address
40 W CACHE VALLEY BLVD STE 10A, LOGAN, UT 84341-8450
(435) 787-2272
(435) 713-4001
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10831025-3501
UT
Other
Enumeration date
07/21/2021
Last updated
07/21/2021
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