Individual
MISS STACEY L. ATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.C.
Contact information
Practice address
288 N IRONWOOD DR, SUITE 110, APACHE JUNCTION, AZ 85120-3830
(480) 982-2356
Mailing address
11112 E SANTINO AVE, MESA, AZ 85212-2610
(480) 540-0265
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-11357
AZ
101YP2500X
Professional Counselor
Primary
LPC13473
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
346214
—
AZ
Enumeration date
02/06/2008
Last updated
05/26/2015
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