Healthcare Provider Details

I. General information

NPI: 1033533021
Provider Name (Legal Business Name): SONIA STEPHENSON LBSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2014
Last Update Date: 02/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 E SCHUSTER AVE
EL PASO TX
79902-4659
US

IV. Provider business mailing address

1101 E SCHUSTER AVE
EL PASO TX
79902-4659
US

V. Phone/Fax

Practice location:
  • Phone: 915-544-8484
  • Fax: 915-496-0751
Mailing address:
  • Phone: 915-544-8484
  • Fax: 915-496-0751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number57530
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: