Provider Demographics
NPI:1679395529
Name:STADLER, FAITH ELISABETH
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:ELISABETH
Last Name:STADLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2357 WARM SPRINGS RD STE 119
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-5690
Mailing Address - Country:US
Mailing Address - Phone:706-309-2233
Mailing Address - Fax:
Practice Address - Street 1:2357 WARM SPRINGS RD STE 119
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-5690
Practice Address - Country:US
Practice Address - Phone:706-309-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-23-256420106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician