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General NPI Number Information
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NPI Number | 1922639772
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Entity Type | Individual
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Provider Name | STACEY SCHRAGER LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/30/2020
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Last Update Date | 01/30/2020
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Provider Practice Location Address
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Address Line | 91-1701 ALANUI MAUKA PL
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City | EWA BEACH
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State | HI
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Zip | 96706-1906
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Country | US
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Telephone | 808-772-3763
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Fax |
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Provider Business Mailing Address
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Address Line | 91-1701 ALANUI MAUKA PL
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City | EWA BEACH
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State | HI
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Zip | 96706-1906
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Country | US
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Telephone | 808-772-3763
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT-622
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License Number State | HI
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