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Individual

WAYMON E STALLCUP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
4778 MUSTANG RUN PL, CASTLE ROCK, CO 80109-4574
(303) 242-9418
Mailing address
4778 MUSTANG RUN PL, CASTLE ROCK, CO 80109-4574

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0001257
CO
106H00000X
Marriage & Family Therapist
Primary
MFT.0001312
CO

Other

Enumeration date
05/17/2023
Last updated
05/17/2023
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