Provider Demographics
NPI:1902102098
Name:STOPLER, ROBERTA (LMFT, LPC)
Entity Type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:
Last Name:STOPLER
Suffix:
Gender:F
Credentials:LMFT, LPC
Other - Prefix:MS
Other - First Name:ROBERTA
Other - Middle Name:STOPLER
Other - Last Name:GRIECO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:548 SW 13RH STREET, SUITE 201
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702
Mailing Address - Country:US
Mailing Address - Phone:541-318-4277
Mailing Address - Fax:541-593-4074
Practice Address - Street 1:548 SW 13TH STREET, SUITE 201
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702
Practice Address - Country:US
Practice Address - Phone:541-318-4277
Practice Address - Fax:541-593-4074
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT0628106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist