Provider Demographics
NPI:1598191892
Name:STAMP, MARIA CECILIA J
Entity Type:Individual
Prefix:
First Name:MARIA CECILIA
Middle Name:J
Last Name:STAMP
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 1:2036 LINCOLN AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-6516
Mailing Address - Country:US
Mailing Address - Phone:801-719-7737
Mailing Address - Fax:888-887-9784
Practice Address - Street 1:2036 LINCOLN AVE STE 102
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84401-6516
Practice Address - Country:US
Practice Address - Phone:801-719-7737
Practice Address - Fax:888-887-9784
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-18
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program