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NPI Code Detail

MEDICARE: MS. STEPHANIE SUE STEVENSON

MEDICARE: MS. STEPHANIE SUE STEVENSON
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
1101YM0800XMental Health Counselor6801085628MI

General Provider Information

NPI Number : 1952598948
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STEPHANIE SUE STEVENSON
Provider Business Mailing Address
First Line : 690 S TRUMBULL ST
Second Line :
City : BAY CITY
State : MI
Zip : 48708-7692
Country : US
Telephone Number : 989-922-4900
Fax Number : 989-922-4911
Provider Business Practice Location Address
First Line : 690 S TRUMBULL ST
Second Line :
City : BAY CITY
State : MI
Zip : 48708-7692
Country : US
Telephone Number : 989-922-4900
Fax Number : 989-922-4911
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2007
Last Update Date : 10/03/2007

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Directions to “ MS. STEPHANIE SUE STEVENSON ” Practice Location

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