Individual
THERESA FAYE STOTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
933 RUSSELL RD., STE 93, COLUMBIA, KY 42728
(270) 384-1736
Mailing address
933 RUSSELL RD., STE 93, COLUMBIA, KY 42728
(270) 384-1736
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
276256
KY
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100807930
—
KY
Enumeration date
02/15/2019
Last updated
06/16/2022
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