| Doctor Name: | MRS. TAMALA SURELL STUBBS |
| NPI Number: | 1942542717 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 501 Lumberton Rd Columbia, MS - 394293515 |
| Business Phone Number: | 6017369980 |
| Business Fax Number: | |
| Mailing Address: | 501 A Lumberton Rd, COLUMBIA |
| State: | MS |
| Postal Code: | 394293515 |
| Phone Number: | 6017369980 |
| Fax Number: | |
| NPI Enumeration Date: | 03/20/2013 |
| NPI Last Update Date: | 03/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385H00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |