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General NPI Number Information
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NPI Number | 1043166143
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Entity Type | Individual
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Provider Name | STACY ANN SASSE
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Gender |
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 15 10TH AVE
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City | SHALIMAR
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State | FL
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Zip | 32579-1340
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Country | US
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Telephone | 865-368-6584
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Fax |
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Provider Business Mailing Address
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Address Line | 2005 EVERGLADES DR
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City | NAVARRE
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State | FL
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Zip | 32566-7665
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Country | US
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Telephone | 865-368-6584
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | FL
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