Individual
STACY SUH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
712 IRVING AVE, WHEATON, IL 60187-4257
(201) 705-3078
Mailing address
7 W 36TH ST FL 15, NEW YORK, NY 10018-7151
(212) 203-9792
(212) 320-0321
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OSC05699186-03
OSCAR
—
Enumeration date
03/07/2023
Last updated
09/03/2024
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