Individual
STEPHANIE PRATOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
2017 JEFFERSON ST SW, ROANOKE, VA 24014-2419
(540) 853-0900
(540) 853-0518
Mailing address
2017 JEFFERSON ST SW, ROANOKE, VA 24014-2419
(540) 853-0863
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810001014
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007728581
—
VA
Enumeration date
08/31/2006
Last updated
12/26/2018
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