Provider Demographics
NPI:1780186718
Name:STUNTZ, BRIDGET RENEE (CPRS)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:RENEE
Last Name:STUNTZ
Suffix:
Gender:F
Credentials:CPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23215 COMMERCE PARK # 205
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5803
Mailing Address - Country:US
Mailing Address - Phone:216-407-6278
Mailing Address - Fax:216-647-0613
Practice Address - Street 1:23215 COMMERCE PARK # 205
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5803
Practice Address - Country:US
Practice Address - Phone:216-407-6278
Practice Address - Fax:216-647-0613
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH00414175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist