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General NPI Number Information
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NPI Number | 1013259969
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Entity Type | Individual
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Provider Name | ROBIN GAYE STUFFLEBEAN RN PC LICDC
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Gender | Female
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Dates
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Enumeration Date | 03/19/2013
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Last Update Date | 03/19/2013
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Provider Practice Location Address
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Address Line | 76 ASHWOOD DR
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City | TIFFIN
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State | OH
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Zip | 44883-1908
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Country | US
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Telephone | 419-448-9440
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Fax | 419-448-5155
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Provider Business Mailing Address
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Address Line | 1925 HAYES AVE
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City | SANDUSKY
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State | OH
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Zip | 44870-4737
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Country | US
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Telephone | 419-557-5177
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Fax | 419-557-5179
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | C1200155
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ICDC081097
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN240023
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License Number State | OH
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