Individual
MICHELLE STOCKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TCADC
Contact information
Practice address
1527 ALBIA RD, OTTUMWA, IA 52501-3907
(641) 682-8772
(641) 682-1924
Mailing address
1527 ALBIA RD, OTTUMWA, IA 52501-3907
(641) 682-8772
(641) 682-1924
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T19000
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659353670
—
IA
Enumeration date
02/12/2019
Last updated
02/12/2019
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