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General NPI Number Information
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NPI Number | 1053563189
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Entity Type | Individual
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Provider Name | STACEY MARIE MOSTEK MS, PLMHP
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Gender | Female
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 10/21/2008
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Provider Practice Location Address
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Address Line | 2041 E 56TH ST
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City | KEARNEY
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State | NE
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Zip | 68847-4179
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Country | US
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Telephone | 308-236-7145
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Fax | 308-236-7150
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Provider Business Mailing Address
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Address Line | 2102 W 37TH ST
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City | KEARNEY
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State | NE
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Zip | 68845-2219
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Country | US
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Telephone | 402-380-0313
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 8625
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License Number State | NE
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