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Individual

DR. STACEY DEVAUX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
565 ROUTE 25A STE 201, MILLER PLACE, NY 11764-2600
(631) 828-0307
Mailing address
72 VAN BUREN ST, PORT JEFF STA, NY 11776-3172
(163) 182-8030

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
016842
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
016842
LICENSE
NY
Enumeration date
12/23/2018
Last updated
12/23/2018
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