Provider Demographics
NPI:1235024753
Name:STAUFFER, TIA SUZANNE
Entity type:Individual
Prefix:
First Name:TIA
Middle Name:SUZANNE
Last Name:STAUFFER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 SUMNEYTOWN PIKE STE 200
Mailing Address - Street 2:
Mailing Address - City:LOWER GWYNEDD
Mailing Address - State:PA
Mailing Address - Zip Code:19002-1321
Mailing Address - Country:US
Mailing Address - Phone:267-405-3114
Mailing Address - Fax:
Practice Address - Street 1:904 SUMNEYTOWN PIKE STE 200
Practice Address - Street 2:
Practice Address - City:LOWER GWYNEDD
Practice Address - State:PA
Practice Address - Zip Code:19002-1321
Practice Address - Country:US
Practice Address - Phone:267-405-3114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor