Provider Demographics
NPI:1851098446
Name:PRIESTLEY, STACIE (IHC)
Entity Type:Individual
Prefix:
First Name:STACIE
Middle Name:
Last Name:PRIESTLEY
Suffix:
Gender:F
Credentials:IHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1933 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:WV
Mailing Address - Zip Code:25177-1916
Mailing Address - Country:US
Mailing Address - Phone:304-552-5111
Mailing Address - Fax:
Practice Address - Street 1:103 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-2314
Practice Address - Country:US
Practice Address - Phone:304-756-5715
Practice Address - Fax:681-205-2877
Is Sole Proprietor?:No
Enumeration Date:2023-02-14
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach