Individual
DR. STACEY BOLEY SANDUSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
13000 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4745
(813) 972-2000
(813) 631-3188
Mailing address
13000 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4745
(813) 972-2000
(813) 631-3188
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 8569
FL
Other
Enumeration date
08/30/2012
Last updated
08/30/2012
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