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General NPI Number Information
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NPI Number | 1699947804
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Entity Type | Individual
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Provider Name | STACEY L. MAPLES PHD
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Gender | Female
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 07/23/2015
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Provider Practice Location Address
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Address Line | 1407 S ELLIOTT AVE STE B
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City | AURORA
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State | MO
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Zip | 65605-2103
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Country | US
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Telephone | 417-440-0826
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Fax | 888-602-7956
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Provider Business Mailing Address
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Address Line | 1407 S ELLIOTT AVE STE B
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City | AURORA
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State | MO
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Zip | 65605-2103
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Country | US
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Telephone | 417-440-0826
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Fax | 888-602-7956
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2008007986
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY6345
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License Number State | FL
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