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General NPI Number Information
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NPI Number | 1427703461
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Entity Type | Individual
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Provider Name | SUSAN MARIE STUNTZNER PHD, LPC, LMHP, LCPC
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Gender | Female
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Dates
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Enumeration Date | 02/17/2022
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 1988 NEWMARK AVE
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City | COOS BAY
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State | OR
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Zip | 97420-2912
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Country | US
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Telephone | 541-888-1578
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Fax |
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Provider Business Mailing Address
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Address Line | 1645 N 19TH ST
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City | COOS BAY
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State | OR
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Zip | 97420-2058
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Country | US
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Telephone | 541-260-0710
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C4231
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License Number State | OR
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