Healthcare Provider Details

I. General information

NPI: 1518240415
Provider Name (Legal Business Name): DAWN NICOLE STEPHENS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2011
Last Update Date: 10/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DR HITZELBERGER STRASSE
LANDSTUHL RHEINLAND PFALZ
66849
DE

IV. Provider business mailing address

CMR 403 BOX 4536
APO AE
09059-0046
US

V. Phone/Fax

Practice location:
  • Phone: 491512985129
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1772
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: