Most Relevant Information
Provider Data
| NPI Number: | 1003285354 |
| Provider Name: | STACEY CRANDALL |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/16/2015 |
| Last Updated: | 09/16/2015 |
Provider Practice Location
1409 CLARK ST
DES MOINES
IA
503141964
Practice Location Phone/Fax
| Phone: | 5156436500 |
| Fax: |
Provider Mailing Location
1409 CLARK ST
DES MOINES
IA
503141964
Provider Mailing Phone/Fax
| Phone: | 5156436500 |
| Fax: |