Provider Demographics
NPI:1871209106
Name:STAUDT, BIANCA (MSW)
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:STAUDT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 213
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-0213
Mailing Address - Country:US
Mailing Address - Phone:518-222-0133
Mailing Address - Fax:603-232-3079
Practice Address - Street 1:24 FRONT ST STE 401
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2727
Practice Address - Country:US
Practice Address - Phone:518-222-0133
Practice Address - Fax:603-232-3079
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical