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General NPI Number Information
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NPI Number | 1023652567
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Entity Type | Individual
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Provider Name | REBECCA STAUFFER MA, RD, LPC
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Gender | Female
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Dates
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Enumeration Date | 10/28/2019
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 306 1/2 EAST MAIN STREET
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City | BUENA VISTA
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State | CO
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Zip | 81211
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Country | US
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Telephone | 719-351-0892
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 184
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City | BUENA VISTA
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State | CO
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Zip | 81211-0184
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Country | US
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Telephone | 719-351-0892
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC.0016812
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 86034734
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License Number State | CO
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