Michelle E. Stack PH.D.
Full Name
Michelle Elena Stack PH.D.
NPI Number
1952671950
NPI Type
Individual Provider
Gender
Female
Enumeration Date
01/06/2012
Specialties
(Taxonomies)Name
Code
103G00000X
103TC0700X
103TB0200X
103TH0004X
103T00000X
Primary Taxonomy
No
No
No
No
No
Licenses
State
Connecticut
New Mexico
License Number
3230
1195
Contact
Information
Purpose
Mailing
Location
Address
1090 S TAMIAMI TRL
1090 S TAMIAMI TRL
City
Sarasota
Sarasota
State
FL
FL
Postal Code
34236-9116
34236-9116
Country
US
US
Telephone Number
N/A
(941) 363-0878
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 09/19/2022