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Stacey Lane

Case Manager/Care Coordinator in Jay, OK. Individual provider (NPI-1).

NPI number1164057584
StatusActive
Last updated in NPPESMar 5, 2020

Details

NPI
1164057584
Entity type
Individual (NPI-1)
Name
Stacey Lane
Sex
Female
Sole proprietor
No
Enumeration date
Mar 5, 2020
Certification date
Mar 5, 2020
Last updated
Mar 5, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171M00000X Case Manager/Care Coordinator––Yes

Practice location

1015 W Washbourne St
Jay, OK 74346-4205

Phone 918-308-5513

Mailing address

1015 W Washbourne
Jay, OK 74346-4205

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