Individual
LISA P STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,CSP
Contact information
Practice address
104 SISTERSVILLE PIKE, WEST UNION, WV 26456-1034
(304) 624-6554
(304) 624-5223
Mailing address
104 SISTERSVILLE PIKE, WEST UNION, WV 26456-1034
(304) 624-6554
(304) 624-5223
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
11106
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0166396000
—
WV
Enumeration date
03/17/2008
Last updated
03/17/2008
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