Provider Demographics
NPI:1851265144
Name:STUMBAUGH, GEENA ROSE
Entity type:Individual
Prefix:
First Name:GEENA
Middle Name:ROSE
Last Name:STUMBAUGH
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 CEDAR LODGE RD
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-6143
Mailing Address - Country:US
Mailing Address - Phone:366-474-2211
Mailing Address - Fax:
Practice Address - Street 1:232 CEDAR LODGE RD
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-6143
Practice Address - Country:US
Practice Address - Phone:336-474-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-01
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst