Individual
STACEY S, ORVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., MFT
Contact information
Practice address
22001 FAIRMOUNT BLVD, BELLEFAIRE JCB, SHAKER HEIGHTS, OH 44118-4819
(216) 932-2800
Mailing address
22001 FAIRMOUNT BLVD, BELLEFAIRE JCB, SHAKER HEIGHTS, OH 44118-4819
(216) 932-2800
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
M. 1500018
OH
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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