MICHELLE ELENA STACK

SARASOTA, FL
NPI1952671950
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy103G00000X Clinical Neuropsychologist
(Licence: FL  11585)
Additional Taxonomies103G00000X Clinical Neuropsychologist
(Licence: CT  3230)
103G00000X Clinical Neuropsychologist
(Licence: NM  1195)
103T00000X Psychologist
(Licence: CT  3230)
103T00000X Psychologist
(Licence: NM  1195)
103TB0200X Psychologist, Cognitive & Behavioral
(Licence: CT  3230)
103TB0200X Psychologist, Cognitive & Behavioral
(Licence: NM  1195)
103TC0700X Psychologist, Clinical
(Licence: CT  3230)
103TC0700X Psychologist, Clinical
(Licence: NM  1195)
103TH0004X Psychologist, Health
(Licence: NM  1195)
103TR0400X Psychologist, Rehabilitation
(Licence: CT  3230)
103TR0400X Psychologist, Rehabilitation
(Licence: NM  1195)
Enumeration Date2012-01-06
Last Update Date2022-09-19
Business Address
MICHELLE ELENA STACK Ph.D.
1090 S TAMIAMI TRL
SARASOTA, FL 34236-9116
Phone number: 941-363-0878
Mailing Address
MICHELLE ELENA STACK Ph.D.
1090 S TAMIAMI TRL
SARASOTA, FL 34236-9116
Phone number: