Most Relevant Information
Provider Data
| NPI Number: | 1003390535 |
| Provider Name: | STACIA MACKLIN |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 0904003859 |
Most Important Dates
| Enumeration Date: | 09/20/2018 |
| Last Updated: | 09/20/2018 |
Provider Practice Location
5016 BROAD MEADOWS RD
GLEN ALLEN
VA
230603158
Practice Location Phone/Fax
| Phone: | 8048362931 |
| Fax: |
Provider Mailing Location
5016 BROAD MEADOWS RD
GLEN ALLEN
VA
230603158
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |