Provider Demographics
NPI:1639317373
Name:UTAY, STACY MILLER (MS, CGC)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:MILLER
Last Name:UTAY
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIV OF TEXAS SOUTHWESTERN MEDICAL CTR
Mailing Address - Street 2:5323 HARRY HINES BOULEVARD
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-0001
Mailing Address - Country:US
Mailing Address - Phone:214-648-5964
Mailing Address - Fax:214-648-1666
Practice Address - Street 1:UNIV OF TEXAS SOUTHWESTERN MEDICAL CTR
Practice Address - Street 2:5323 HARRY HINES BOULEVARD
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-0001
Practice Address - Country:US
Practice Address - Phone:214-648-5964
Practice Address - Fax:214-648-1666
Is Sole Proprietor?:No
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS