Provider Demographics
NPI:1841732393
Name:WARD, STACEY ANN LAFAVE (QBHP)
Entity type:Individual
Prefix:MS
First Name:STACEY
Middle Name:ANN LAFAVE
Last Name:WARD
Suffix:
Gender:F
Credentials:QBHP
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Other - Credentials:
Mailing Address - Street 1:358 KILLARNEY BEACH RD
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-1185
Mailing Address - Country:US
Mailing Address - Phone:989-737-3575
Mailing Address - Fax:
Practice Address - Street 1:3253 CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3106
Practice Address - Country:US
Practice Address - Phone:989-793-4790
Practice Address - Fax:989-793-1641
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2018-03-22
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst