Provider Demographics
NPI:1790749745
Name:STOODY, TINA MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:TINA
Middle Name:MARIE
Last Name:STOODY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:UNIVERSITY OF NORTHERN COLORADO 501 20TH ST
Mailing Address - Street 2:CAMPUS BOX 55
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80639-0001
Mailing Address - Country:US
Mailing Address - Phone:970-351-2012
Mailing Address - Fax:970-351-1601
Practice Address - Street 1:UNC SPEECH AND AUDIOLOGY CLINIC
Practice Address - Street 2:GUNTER HALL ROOM 0330
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80639-0001
Practice Address - Country:US
Practice Address - Phone:970-351-2012
Practice Address - Fax:970-351-1601
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO450231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist