Provider Demographics
NPI:1013554104
Name:SPANGLER, STEPHANIE J (MSW)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:J
Last Name:SPANGLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4706 MARION EMORY DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-4180
Mailing Address - Country:US
Mailing Address - Phone:540-207-9239
Mailing Address - Fax:
Practice Address - Street 1:8020 RIVER STONE DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-8761
Practice Address - Country:US
Practice Address - Phone:540-834-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-08
Last Update Date:2019-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPPS-0605575OtherPUPIL PERSONNEL SERVICES LICENSE