Individual
STACEY ELIZABETH ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1125 6TH ST SE, WILLMAR, MN 56201-4675
(320) 235-4613
Mailing address
1125 6TH ST SE, WILLMAR, MN 56201-4675
(320) 235-4613
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC03941
MN
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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