Provider Demographics
NPI:1619202769
Name:STUTSMAN, BARBARA A
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:STUTSMAN
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 1:4115 BOARDWALK DR UNIT 100
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5945
Mailing Address - Country:US
Mailing Address - Phone:970-690-7450
Mailing Address - Fax:
Practice Address - Street 1:4115 BOARDWALK DR UNIT 100
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5945
Practice Address - Country:US
Practice Address - Phone:970-690-7450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-07
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO974106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist