Individual
STACY ILENE BENHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2601 S GRAND CANYON DR APT 2003, LAS VEGAS, NV 89117-3671
(626) 684-6349
Mailing address
2601 S GRAND CANYON DR APT 2003, LAS VEGAS, NV 89117-3671
(626) 684-6349
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8186-C
NV
Other
Enumeration date
05/12/2020
Last updated
05/12/2020
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