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General NPI Number Information
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NPI Number | 1902262397
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Entity Type | Individual
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Provider Name | TAMMY LYNN STEVENS BACHELOR OF SCIENCE
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Gender | Female
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Dates
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Enumeration Date | 01/14/2016
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Last Update Date | 05/15/2018
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Provider Practice Location Address
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Address Line | 1589 HILL RISE DR
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City | LEXINGTON
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State | KY
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Zip | 40504
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Country | US
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Telephone | 859-977-2508
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Fax | 859-223-9231
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Provider Business Mailing Address
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Address Line | 125 S MAIN CROSS ST
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City | LOUISA
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State | KY
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Zip | 41230-1065
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Country | US
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Telephone | 859-972-0045
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 240098
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License Number State | KY
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