MEDICARE: PATRICIA A STEPHENS MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SLP0978	AZ

General Provider Information

NPI Number	:	1093837742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA A STEPHENS MA

Provider Business Mailing Address
First Line	:	4057 W. TREECE WAY
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5656 E GRANT RD
Second Line	:	SUITE 100
City	:	TUCSON
State	:	AZ
Zip	:	85712-2210
Country	:	US
Telephone Number	:	520-885-9567
Fax Number	:	520-885-9568

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	07/08/2007

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Directions to “ PATRICIA A STEPHENS MA” Practice Location

Language	Start Address	Practice Location

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