Individual
VIVIAN STAMBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2345 E STATE ROAD 14, SILVER LAKE, IN 46982-8817
(260) 839-0308
Mailing address
2345 E STATE ROAD 14, SILVER LAKE, IN 46982-8817
(260) 557-3805
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/15/2021
Last updated
04/15/2021
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