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General NPI Number Information
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NPI Number | 1588834725
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Entity Type | Individual
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Provider Name | GLENDORIA STEPHENS LMHC
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Gender | Female
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Dates
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Enumeration Date | 03/04/2008
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 119 S PALMETTO AVE STE 234
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-4387
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Country | US
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Telephone | 407-701-6658
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Fax |
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Provider Business Mailing Address
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Address Line | 119 S PALMETTO AVE STE 234
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-4387
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Country | US
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Telephone | 407-701-6658
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Fax | 386-323-2274
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MH8403
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License Number State | FL
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