Individual
STACEY LYNN GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ALC
Contact information
Practice address
401 HUGHES RD STE 2, MADISON, AL 35758-1144
(412) 287-7088
Mailing address
110 MILL WALK CT, MADISON, AL 35758-1545
(412) 287-7088
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
ALC04091
AL
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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