Most Relevant Information
Provider Data
| NPI Number: | 1003234972 |
| Provider Name: | STACI POE |
| Entity Type: | Individual |
| Taxonomy Code: | 101YP2500X |
| Specialty: | Counselor |
| License Number: | 178.009748 |
Most Important Dates
| Enumeration Date: | 03/28/2014 |
| Last Updated: | 03/28/2014 |
Provider Practice Location
44 E MAIN ST
STE 406
CHAMPAIGN
IL
618203636
Practice Location Phone/Fax
| Phone: | 2173989066 |
| Fax: | 2173989077 |
Provider Mailing Location
44 E MAIN ST
STE 406
CHAMPAIGN
IL
618203636
Provider Mailing Phone/Fax
| Phone: | 2173989066 |
| Fax: | 2173989077 |