Individual
STACY YOUNGBLOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
503 BROKEN SHALE CIR, HENDERSON, NV 89052-2890
(702) 241-7166
Mailing address
503 BROKEN SHALE CIR, HENDERSON, NV 89052-2890
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MI0358
NV
106H00000X
Marriage & Family Therapist
Primary
4263
NV
106H00000X
Marriage & Family Therapist
MI0358
NV
Other
Enumeration date
10/26/2012
Last updated
08/24/2022
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