Provider Demographics
NPI:1508533134
Name:STUCKEY, AUBRIANNA LYNN
Entity Type:Individual
Prefix:
First Name:AUBRIANNA
Middle Name:LYNN
Last Name:STUCKEY
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 1:6187 56TH PL N
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-1815
Mailing Address - Country:US
Mailing Address - Phone:727-251-2911
Mailing Address - Fax:
Practice Address - Street 1:3100 75TH ST N STE 2
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-2326
Practice Address - Country:US
Practice Address - Phone:727-371-9975
Practice Address - Fax:727-491-5379
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician