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General NPI Number Information
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NPI Number | 1164248225
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Entity Type | Individual
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Provider Name | MRS. LAURINDA MARGARET STEPHENS
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Gender | Female
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 332 S MICHIGAN AVE STE 900
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City | CHICAGO
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State | IL
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Zip | 60604-4393
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Country | US
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Telephone | 217-491-8403
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Fax | 772-675-9100
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Provider Business Mailing Address
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Address Line | 7058 E IL ROUTE 72 LOT 5
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City | STILLMAN VALLEY
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State | IL
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Zip | 61084-9620
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Country | US
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Telephone | 608-289-3045
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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