Individual
ELIZABETH STACOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
703 MAIN ST, PATERSON, NJ 07503-2621
(973) 754-3081
Mailing address
703 MAIN ST, PATERSON, NJ 07503-2621
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
020101
NY
103T00000X
Psychologist
Primary
35S100545800
NJ
Other
Enumeration date
06/05/2013
Last updated
09/18/2015
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