Individual
STACY SANDERS SHAUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
10100 W SAMPLE RD, SUITE 331, CORAL SPRINGS, FL 33065-3973
(954) 752-9353
(954) 752-9353
Mailing address
10100 W SAMPLE RD, SUITE 331, CORAL SPRINGS, FL 33065-3973
(954) 752-9353
(954) 752-9353
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY 7280
FL
Other
Enumeration date
05/28/2006
Last updated
06/07/2016
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