Provider Demographics
NPI:1346662897
Name:STOKES, STACIA
Entity Type:Individual
Prefix:
First Name:STACIA
Middle Name:
Last Name:STOKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6655 BOULDER HWY
Mailing Address - Street 2:1191
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89122-7418
Mailing Address - Country:US
Mailing Address - Phone:330-323-9518
Mailing Address - Fax:
Practice Address - Street 1:6655 BOULDER HWY APT 1191
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89122-7733
Practice Address - Country:US
Practice Address - Phone:330-323-9518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-16
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst