Healthcare Provider Details

I. General information

NPI: 1316230154
Provider Name (Legal Business Name): CYNTHIA ANN STEPHENSON MA, QMHA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2011
Last Update Date: 03/18/2020
Certification Date: 03/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 BAR NONE LANE
SPRING CREEK NV
89815-8981
US

IV. Provider business mailing address

PO BOX 8514
SPRING CREEK NV
89815-0009
US

V. Phone/Fax

Practice location:
  • Phone: 775-881-8249
  • Fax:
Mailing address:
  • Phone: 775-881-8249
  • Fax: 775-851-8629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: