| John Bryan Stuppy | |
|
2891 Clark Ct Santa Fe NM 87507-5179 | |
| (505) 930-4550 | |
| Not Available |
| Full Name | John Bryan Stuppy |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2891 Clark Ct, Santa Fe, New Mexico |
| Authorized Official Name and Position | John Bryan Stuppy (CLINICAL SOCIAL WORKE) |
| Authorized Official Contact | 5059304550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John Bryan Stuppy 2891 Clark Ct Santa Fe NM 87507-5179 Ph: (505) 930-4550 | John Bryan Stuppy 2891 Clark Ct Santa Fe NM 87507-5179 Ph: (505) 930-4550 |
| NPI Number | 1649579780 |
|---|---|
| Provider Enumeration Date | 03/15/2011 |
| Last Update Date | 03/15/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649579780 | NPI | - | NPPES |
| 53052552 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | I-06160 (New Mexico) | Primary |
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