Provider Demographics
NPI:1386064509
Name:STUTZMAN, BETH N (PSYD)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:N
Last Name:STUTZMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8479 SAINT ANTHONYS RD
Mailing Address - Street 2:
Mailing Address - City:KING GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:22485-3408
Mailing Address - Country:US
Mailing Address - Phone:540-775-9879
Mailing Address - Fax:549-775-3887
Practice Address - Street 1:16705 SAINT CLAIR AVE STE 303
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-9470
Practice Address - Country:US
Practice Address - Phone:330-932-1594
Practice Address - Fax:330-368-0067
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004986103TC0700X
OHP.O7771103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical