Healthcare Provider Details

I. General information

NPI: 1164330429
Provider Name (Legal Business Name): BRIANNA RAE STEPHENSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 FERREL ST
PLATTE CITY MO
64079-9511
US

IV. Provider business mailing address

16665 HUNTERS RIDGE LN APT I
SAINT ROBERT MO
65584-4851
US

V. Phone/Fax

Practice location:
  • Phone: 816-469-5162
  • Fax:
Mailing address:
  • Phone: 573-647-7090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: