Provider Information for 1467714469
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STACEY HEATHER SUGAR lcpc
Sex: Female
NPI: 1467714469
Last Updated: 2012-06-14
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1467714469 | ||||||||
| Enumeration Date | 2012-06-14 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1777 REISTERSTOWN RD SUITE 268 PIKESVILLE, MD 21208-1306 United States Phone: 410-653-7353 | Fax: | ||||||||
| Primary Practice Address | 1777 REISTERSTOWN RD SUITE 268 PIKESVILLE, MD 21208-1306 United States Phone: 410-653-7353 | Fax: | ||||||||
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