Provider Demographics
NPI:1447801014
Name:STIFFLER, REBECCA LYNN (HIS)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LYNN
Last Name:STIFFLER
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34728 PLYMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1440
Mailing Address - Country:US
Mailing Address - Phone:734-838-9990
Mailing Address - Fax:734-838-9991
Practice Address - Street 1:34728 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1440
Practice Address - Country:US
Practice Address - Phone:734-838-9990
Practice Address - Fax:734-838-9991
Is Sole Proprietor?:No
Enumeration Date:2019-09-25
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501008996237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist