Provider Demographics
NPI:1487465548
Name:MUEMA, STACY NZISA
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:NZISA
Last Name:MUEMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 N 7TH ST APT 13
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-2916
Mailing Address - Country:US
Mailing Address - Phone:267-299-3006
Mailing Address - Fax:
Practice Address - Street 1:605 HIGH ST
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NJ
Practice Address - Zip Code:08060-1022
Practice Address - Country:US
Practice Address - Phone:609-267-3610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health