Provider Demographics
NPI:1942650304
Name:STILLINGER, AMELIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AMELIA
Middle Name:
Last Name:STILLINGER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:494 H ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-6370
Mailing Address - Country:US
Mailing Address - Phone:707-273-1347
Mailing Address - Fax:
Practice Address - Street 1:494 H ST
Practice Address - Street 2:SUITE A
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6370
Practice Address - Country:US
Practice Address - Phone:707-273-1347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28019103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical