Individual
STACI L DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.S ; NASP
Contact information
Practice address
8735 INDIAN CREEK RD S, INDIANAPOLIS, IN 46259-1330
(317) 803-5987
Mailing address
4747 MADISON AVE, INDIANAPOLIS, IN 46227-4149
(740) 601-1736
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
10269045
IN
Other
Enumeration date
10/21/2024
Last updated
10/21/2024
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