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General NPI Number Information
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NPI Number | 1083013304
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Entity Type | Individual
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Provider Name | STEPHANIE ANN STEPHENS MS
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Gender | Female
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Dates
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Enumeration Date | 08/22/2014
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 19108 120TH RD
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City | SAINT ALBANS
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State | NY
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Zip | 11412-3619
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Country | US
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Telephone | 718-791-3753
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Fax |
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Provider Business Mailing Address
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Address Line | 25704 149TH AVE
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City | ROSEDALE
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State | NY
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Zip | 11422-3021
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Country | US
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Telephone | 718-791-3753
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 1278088
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License Number State | NY
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