Individual
DR. STEPHANIE ELIZABETH STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W FORT ST BLDG 23, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
1810 W BANNOCK ST, BOISE, ID 83702-5108
(714) 425-1605
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
01/20/2019
Last updated
01/20/2019
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