Individual
MR. NATHAN JON STACKHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2380 3RD ST, BULLHEAD CITY, AZ 86429-5502
(567) 224-8821
Mailing address
1004 HANCOCK RD, BULLHEAD CITY, AZ 86442-5946
(567) 224-8821
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
Primary
3941434
AZ
Other
Enumeration date
09/26/2007
Last updated
09/26/2007
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