Individual
MARY CLARICE STAMPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
450 WINN WAY, DEKALB CRISIS CENTER, DECATUR, GA 30030-1715
(404) 294-0499
(404) 294-0793
Mailing address
1836 SILVER HILL RD, STONE MTN, GA 30087-2213
(770) 491-0736
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN033252
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN033252
PROFESSIONAL LICENSE
GA
Enumeration date
04/20/2007
Last updated
07/08/2007
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