Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 14346 | MD |
N | 1041C0700X | Clinical Social Worker | Q1-0000898 | DE |
NPI | 1003097999 |
---|---|
Provider Name | Mrs. Stacy Erin Doney |
First Address | Elkton, MD 21921-4506 |
Second Address | Elkton, MD 21921-4506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2007 |
Last Update Date | 13/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003097999 | (05) | MD |
247242ZDVL | (02) | DE |