STACEY CLARE HOSTETTER
Individual Provider (NPI-1)
Active
Psychologist, Clinical
Provider Information
- NPI Number
1861257685- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 11660 ROUND LAKE BLVD NW, COON RAPIDS, MN, 554332638
- Phone
- (763) 767-3350
Specialties & Taxonomies
Psychologist, Clinical
Primary License: MN #NA