Individual
STACY GRIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
216 N STATE ST, NORTH VERNON, IN 47265-1453
(812) 346-4468
Mailing address
216 N STATE ST, NORTH VERNON, IN 47265-1453
(812) 346-4468
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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