Individual
DIANE STAKOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMBT
Contact information
Practice address
8384 SIX FORKS RD, SUITE 203, RALEIGH, NC 27615-5079
(919) 349-2673
Mailing address
8384 SIX FORKS RD, SUITE 203, RALEIGH, NC 27615-5079
(919) 349-2673
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7499
NC
Other
Enumeration date
08/11/2013
Last updated
08/11/2013
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