Individual
STACEY COLLEEN UEBERSAX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2002 CLIPPER PARK RD, SUITE 110, BALTIMORE, MD 21211-1405
(410) 554-0099
(410) 889-8971
Mailing address
2002 CLIPPER PARK RD, SUITE 110, BALTIMORE, MD 21211-1405
(410) 554-0099
(410) 889-8971
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
03962
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03962
LICENSE NUMBER
MD
Enumeration date
05/07/2007
Last updated
07/08/2007
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