Provider Demographics
NPI:1033989488
Name:STOPPLEWORTH, ANNA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:STOPPLEWORTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5354 42ND ST S STE B
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-4032
Mailing Address - Country:US
Mailing Address - Phone:701-630-5018
Mailing Address - Fax:
Practice Address - Street 1:5354 42ND ST S STE B
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4032
Practice Address - Country:US
Practice Address - Phone:701-941-4503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional