Individual
RUTH STOTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5180 FEARNLEY RD, LAKE WORTH, FL 33467-5649
(561) 313-4937
(561) 642-0530
Mailing address
5180 FEARNLEY RD, LAKE WORTH, FL 33467-5649
(561) 313-4937
(561) 642-0530
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010939000
—
FL
Enumeration date
05/24/2019
Last updated
07/27/2019
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