Provider Information for 1215359633
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STACIA NEALS LPC
Sex: Female
NPI: 1215359633
Last Updated: 2024-11-14
Certification Date: 2024-11-11
Certification Date: 2024-11-11
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1215359633 | ||||||||||||
| Enumeration Date | 2014-01-21 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 42 LARKSPUR DR DAYTON, NJ 08810-1450 United States Phone: 732-485-6447 | Fax: | ||||||||||||
| Primary Practice Address | 151 CENTENNIAL AVE PISCATAWAY, NJ 08854-3907 United States Phone: 732-580-0090 | Fax: | ||||||||||||
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