Provider Demographics
NPI:1174244925
Name:STAHL, GLORIA SOTO
Entity type:Individual
Prefix:
First Name:GLORIA
Middle Name:SOTO
Last Name:STAHL
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 1:1155 TABB RD
Mailing Address - Street 2:
Mailing Address - City:CECILIA
Mailing Address - State:KY
Mailing Address - Zip Code:42724-9776
Mailing Address - Country:US
Mailing Address - Phone:502-378-2433
Mailing Address - Fax:
Practice Address - Street 1:107 CRANES ROOST CT
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-3650
Practice Address - Country:US
Practice Address - Phone:888-344-8066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor