Individual
STACIE SHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.S.
Contact information
Practice address
244 N 7TH ST, MARIETTA, OH 45750-2269
(740) 376-2468
(740) 376-2468
Mailing address
244 N 7TH ST, MARIETTA, OH 45750-2269
(740) 376-2468
(740) 376-2468
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
20624864
OH
103TS0200X
School Psychologist
SP 586
OH
Other
Enumeration date
06/04/2015
Last updated
06/04/2015
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