Provider Demographics
NPI:1982256608
Name:ZABEL, STACY ELAINE
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:ELAINE
Last Name:ZABEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STACY
Other - Middle Name:ELAINE
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5140 COBBLESTONE RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-9671
Mailing Address - Country:US
Mailing Address - Phone:507-330-3568
Mailing Address - Fax:
Practice Address - Street 1:5140 COBBLESTONE RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-9671
Practice Address - Country:US
Practice Address - Phone:507-330-3568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician