Healthcare Provider Details

I. General information

NPI: 1720072648
Provider Name (Legal Business Name): THOMAS PAUL STOFFEL MSW,LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 S WILMOT RD B-200
TUCSON AZ
85711-4032
US

IV. Provider business mailing address

326 S WILMOT RD B-200
TUCSON AZ
85711-4032
US

V. Phone/Fax

Practice location:
  • Phone: 520-577-8999
  • Fax: 520-577-8995
Mailing address:
  • Phone: 520-577-8999
  • Fax: 520-577-8995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT-0077
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: