Individual
MS. STACEY LYNN MARQUEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301013480
MI
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
Other
Enumeration date
07/18/2007
Last updated
07/18/2007
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