Provider Demographics
NPI:1902390438
Name:CHRISTINA B. STABLER, PLLC
Entity Type:Organization
Organization Name:CHRISTINA B. STABLER, PLLC
Other - Org Name:NORTHEAST BEHAVIORAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:STABLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:727-437-2870
Mailing Address - Street 1:1840 PENNSYLVANIA AVE NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-1856
Mailing Address - Country:US
Mailing Address - Phone:727-504-1477
Mailing Address - Fax:
Practice Address - Street 1:1507 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-4411
Practice Address - Country:US
Practice Address - Phone:727-437-2870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9483103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty