Provider Demographics
NPI:1689250995
Name:YOQUELET, STACIE ELIZABETH (EDD, NCC, LPC-MHSP)
Entity Type:Individual
Prefix:DR
First Name:STACIE
Middle Name:ELIZABETH
Last Name:YOQUELET
Suffix:
Gender:F
Credentials:EDD, NCC, LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 HANSON CT STE 103
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2765
Mailing Address - Country:US
Mailing Address - Phone:615-320-1155
Mailing Address - Fax:
Practice Address - Street 1:1015 HANSON CT STE 103
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2765
Practice Address - Country:US
Practice Address - Phone:615-320-1155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1479103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN064522850OtherTN DRIVER'S LICENSE