Provider Demographics
NPI:1740568823
Name:HUZIJ, STEPHANIE SHAFFER (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:SHAFFER
Last Name:HUZIJ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 JET STREAM DR STE 205
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3937
Mailing Address - Country:US
Mailing Address - Phone:719-694-2542
Mailing Address - Fax:719-694-2542
Practice Address - Street 1:1710 JET STREAM DR STE 205
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3937
Practice Address - Country:US
Practice Address - Phone:719-694-2542
Practice Address - Fax:719-694-2542
Is Sole Proprietor?:No
Enumeration Date:2011-07-24
Last Update Date:2011-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3612103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical