Healthcare Provider Details

I. General information

NPI: 1003354523
Provider Name (Legal Business Name): STEPHANIE JEAN-LY BESSENT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

528 E SPOKANE FALLS BLVD
SPOKANE WA
99202-5081
US

IV. Provider business mailing address

528 E SPOKANE FALLS BLVD
SPOKANE WA
99202-5081
US

V. Phone/Fax

Practice location:
  • Phone: 509-777-3553
  • Fax: 877-376-3335
Mailing address:
  • Phone: 509-777-3553
  • Fax: 877-376-3335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: