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Organization

STACY SANDERS SHAUP, PHD, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STACY SHAUP PHD (MGRM)
(954) 752-9353
Entity
Organization

Contact information

Practice address
10100 W SAMPLE RD, SUITE 331, CORAL SPRINGS, FL 33065-3973
(954) 752-9353
(954) 752-9353
Mailing address
10100 W SAMPLE RD, SUITE 331, CORAL SPRINGS, FL 33065-3973
(954) 752-9353
(954) 752-9353

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 7280
FL

Other

Enumeration date
10/17/2014
Last updated
06/07/2016
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