Nicole Stackpole, LPC, R-DMT

NPI #1639719974 in Buda, Texas

Provider Information

NPI Number: 1639719974
Entity Type: Individual
Name: Nicole Stackpole, LPC, R-DMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Credential: LPC, R-DMT
Enumeration Date: Jan 15, 2020
Last Updated: Jan 15, 2020

Practice Location

Address: 112 CIMARRON PARK LOOP STE B
City: Buda
State: Texas
ZIP Code: 78610-2850
Phone: (512) 643-0840

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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