Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 34363 | TX |
N | 103TF0200X | Forensic Psychologist | 34363 | TX |
NPI | 1194042648 |
---|---|
Provider Name | Dr. Tanya R Stephanson |
First Address | Brownwood, TX 76801-8024 |
Second Address | Brownwood, TX 76801-8024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2010 |
Last Update Date | 23/04/2010 |