Mardi Stacy PH.D.

NPI 1417025974 - Psychologist - 103TC0700X

NPI Details
NPI 1417025974
Gender Female
Enumeration Date 12/01/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
1718 W JEFFERSON ST
BOISE ID, 83702-3949, US
Phone (208) 424-8130
Fax (208) 424-8137
Business Location
1718 W JEFFERSON ST
BOISE ID, 83702-3949, US
Phone (208) 424-8130
Fax (208) 424-8137
Toxanomy
Taxonomy Code 103TC0700X
License State Idaho
License Number PSY-429
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According to our database, Dr. Mardi Stacy PH.D. NPI is 1417025974, taxonomy code is 103TC0700X and license number is PSY-429, license state is located at Idaho. Mardi Stacy PH.D. physically located at 1718 W Jefferson St, Boise ID, 83702-3949. NPI Number Mardi Stacy PH.D. has the Individual type.

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1417025974 NPI number is provided on an as is basis without warranty of any kind. 1417025974 is maintained by the National Plan & Provider Enumeration System. The contents of Mardi Stacy PH.D. are for informational purposes only.