Individual
LACEY N. STONEBRAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
705 RILEY HOSPITAL DR, INDIANAPOLIS, IN 46202-5109
(317) 274-4779
(317) 948-9806
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34008441A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300046024
—
IN
Enumeration date
12/15/2020
Last updated
01/04/2021
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