MEDICARE: BRITTNEY STEPHENS

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1487171922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTNEY STEPHENS

Provider Business Mailing Address
First Line	:	5737 BIGGER RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45440-2752
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5737 BIGGER RD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45440-2752
Country	:	US
Telephone Number	:	937-262-4521
Fax Number	:

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

Provider Enumeration Date	:	08/25/2017
Last Update Date	:	08/25/2017

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Directions to “ BRITTNEY STEPHENS ” Practice Location

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