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General NPI Number Information
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NPI Number | 1184219990
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Entity Type | Individual
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Provider Name | STEPHANIE ANDREA BAYNES PSYD
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Gender | Female
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 02/21/2024
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Provider Practice Location Address
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Address Line | 9332 STATE ROAD 54 STE 307
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City | TRINITY
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State | FL
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Zip | 34655-1810
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Country | US
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Telephone | 727-999-3311
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Fax | 727-478-4966
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Provider Business Mailing Address
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Address Line | 3988 ORCHARD HILL CIR
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City | PALM HARBOR
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State | FL
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Zip | 34684-4143
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Country | US
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Telephone | 971-386-8900
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY10933
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License Number State | FL
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