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General NPI Number Information
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NPI Number | 1144572801
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Entity Type | Individual
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Provider Name | JUDITH ANN STUBANAS LPC
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Gender | Female
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Dates
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Enumeration Date | 10/04/2012
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Last Update Date | 05/27/2016
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Provider Practice Location Address
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Address Line | 270 HORIZON DR
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City | RALEIGH
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State | NC
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Zip | 27615-4922
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Country | US
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Telephone | 919-845-0623
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Fax | 919-488-1716
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Provider Business Mailing Address
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Address Line | 260 HORIZON DR
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City | RALEIGH
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State | NC
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Zip | 27615-4922
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Country | US
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Telephone | 919-488-0015
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Fax | 919-277-0066
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 8590
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License Number State | NC
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