Individual
STACY MAPLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12444 AGATITE RD, JACKSONVILLE, FL 32258-2302
(904) 325-4911
Mailing address
12444 AGATITE RD, JACKSONVILLE, FL 32258-2302
(904) 325-4911
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
15451
FL
2472E0500X
EEG Technician
Primary
4372
FL
Other
Enumeration date
11/24/2014
Last updated
11/24/2014
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