Individual
STACY ELIZABETH MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
655 E 1300 N, LOGAN, UT 84341-2570
(435) 792-6491
Mailing address
655 E 1300 N, LOGAN, UT 84341
(435) 792-6491
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
7033785-6006
UT
Other
Enumeration date
01/02/2009
Last updated
01/02/2009
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