Individual
NANCY S STORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
204 METRO, SUITE B, JEFFERSON CITY, MO 65109
(573) 634-4591
(573) 634-4792
Mailing address
809 TROY DR, JEFFERSON CITY, MO 65109
(573) 634-0163
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2008014051
MO
Other
Enumeration date
06/16/2009
Last updated
06/16/2009
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