MEDICARE: DR. CHRISTINE FELICIDAD STEPHENSON PH.D.

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	207SC0300X	Clinical Cytogenetics Physician	96208	AZ

General Provider Information

NPI Number	:	1740472224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE FELICIDAD STEPHENSON PH.D.

Provider Business Mailing Address
First Line	:	4310 E COTTON CENTER BLVD
Second Line	:	STE 120
City	:	PHOENIX
State	:	AZ
Zip	:	85040-8852
Country	:	US
Telephone Number	:	602-495-3804
Fax Number	:	602-254-7340

Provider Business Practice Location Address
First Line	:	4310 E COTTON CENTER BLVD
Second Line	:	STE 120
City	:	PHOENIX
State	:	AZ
Zip	:	85040-8852
Country	:	US
Telephone Number	:	602-495-3804
Fax Number	:	602-254-7340

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

Provider Enumeration Date	:	08/17/2007
Last Update Date	:	08/17/2007

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