Individual
MS. STACIE RENEE DEWOLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
2409 HOMER CLAYTON DR, GUNTERSVILLE, AL 35976-2207
(575) 393-3168
(575) 937-4659
Mailing address
2409 HOMER CLAYTON DR, GUNTERSVILLE, AL 35976-2207
(256) 582-3203
(256) 582-3216
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0120951
NM
101YM0800X
Mental Health Counselor
Primary
—
—
104100000X
Social Worker
X-06231
NM
Other
Enumeration date
04/30/2009
Last updated
05/29/2014
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