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NPI Profile for STACY D JEFFERSON in BAYTOWN, TX.
An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction (Substance Use Disorder) |
101YA0400X |
| NPI Number | 1841824828 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 02/27/2020 | |
| Last updated | 02/27/2020 - About 6 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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STACY D JEFFERSON
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STACY D JEFFERSON