Individual
DR. RICHARD WILLIAM STACKHOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
450 BROOME ST APT 5E, NEW YORK, NY 10013-5909
(212) 431-7413
Mailing address
450 BROOME ST APT 5E, NEW YORK, NY 10013-5909
(212) 431-7413
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
12111-1
NY
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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