Individual
DR. STACEY BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
6012 W WILLIAM CANNON DR, B-103, AUSTIN, TX 78749-1980
(512) 423-3146
Mailing address
6012 W WILLIAM CANNON DR, B-103, AUSTIN, TX 78749-1980
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
33152
TX
103TS0200X
School Psychologist
32869
TX
Other
Enumeration date
11/10/2008
Last updated
11/10/2008
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