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General NPI Number Information
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NPI Number | 1528661519
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Entity Type | Individual
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Provider Name | JAMIE LEE STUBLER MA, LADC
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Gender | Female
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Dates
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Enumeration Date | 11/20/2020
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 1246 UNIVERSITY AVE W
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City | SAINT PAUL
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State | MN
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Zip | 55104-4125
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Country | US
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Telephone | 651-359-2075
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Fax | 651-383-4537
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Provider Business Mailing Address
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Address Line | 1246 UNIVERSITY AVE W
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City | SAINT PAUL
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State | MN
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Zip | 55104-4125
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Country | US
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Telephone | 651-359-2075
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Fax | 651-383-4537
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 305530
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License Number State | MN
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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 | CC03352
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License Number State | MN
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