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Individual

STACEY ALLENE GRAZIANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SCHOOL PSYCHOLOGIST

Contact information

Practice address
1990 E LOHMAN AVE STE 213, LAS CRUCES, NM 88001-3172
(801) 609-8037
Mailing address
PO BOX 14003, LAS CRUCES, NM 88013-4003
(801) 609-8037

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
1444
NM
103TC0700X
Clinical Psychologist
Primary
9444446-2501
UT
103TS0200X
School Psychologist
319903
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10856552
NM
Enumeration date
11/07/2006
Last updated
11/24/2025
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