Individual
KIZZIEA TERRY STUBBLEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AAC
Contact information
Practice address
5001 112TH ST E, TACOMA, WA 98446-5307
(253) 531-2103
Mailing address
12201 PACIFIC AVE S, TACOMA, WA 98444-5126
(253) 531-2103
(253) 536-6637
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CG61444852
WA
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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