Individual
RACHEAL STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1085 CANAAN HEIGHTS RD, DAVIS, WV 26260-8007
(304) 851-6643
Mailing address
1085 CANAAN HEIGHTS RD, DAVIS, WV 26260-8007
(304) 851-6643
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-44839
WV
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/05/2020
Last updated
10/02/2020
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