Healthcare Provider Details

I. General information

NPI: 1588837470
Provider Name (Legal Business Name): DEBORAH J STEVENS LIC. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2008
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 ELM ST
SOUTH DARTMOUTH MA
02748-3459
US

IV. Provider business mailing address

PO BOX 444
WESTPORT POINT MA
02791-0444
US

V. Phone/Fax

Practice location:
  • Phone: 508-636-1234
  • Fax:
Mailing address:
  • Phone: 508-636-1234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number545
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: