Stacey Marie Isrow, BS/PSYC, DT
NPI #1649366063 in Crystal Lake, Illinois
Provider Information
- NPI Number
- 1649366063
- Entity Type
- Individual
- Name
- Stacey Marie Isrow, BS/PSYC, DT
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist
- Credential
- BS/PSYC, DT
- Enumeration Date
- Oct 4, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 1799 KINGS GATE LN
- City
- Crystal Lake
- State
- Illinois
- ZIP Code
- 60014-2906
- Phone
- (815) 276-7786
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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