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General NPI Number Information
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NPI Number | 1831323658
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Entity Type | Individual
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Provider Name | STACY COLLEEN NUAR PSYD, LP
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Gender | Female
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Dates
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Enumeration Date | 05/07/2009
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 5777 W MAPLE RD STE 145
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-4471
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Country | US
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Telephone | 734-719-0504
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Fax |
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Provider Business Mailing Address
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Address Line | 30146 WOODBROOK CT
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3061
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Country | US
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Telephone | 248-330-0748
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Fax |
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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 | 6301019829
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License Number State | MI
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