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General NPI Number Information
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NPI Number | 1295179430
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Entity Type | Individual
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Provider Name | SANDY L STOOPS AAC
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Gender | Female
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Dates
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Enumeration Date | 04/18/2013
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 505 29TH ST SE CHARTLEY HOUSE
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City | AUBURN
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State | WA
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Zip | 98002-7541
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Country | US
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Telephone | 253-876-7650
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Fax | 253-876-7651
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Provider Business Mailing Address
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Address Line | 3713 PACIFIC AVE STE E
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City | TACOMA
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State | WA
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Zip | 98418-7845
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Country | US
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Telephone | 253-433-7993
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Fax | 253-540-6886
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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 | CG60290321
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CG60290321
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State | WA
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