Ms. Beverly Louise Stephens
Occupational Therapist - Gerontology
3020 N Victoria Ave
Peoria
, Illinois 61604-2322
Ms. Beverly Louise Stephens
Occupational Therapist - Gerontology
3020 N Victoria Ave
Peoria
, Illinois 61604-2322
(309) 657-8704
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About
Features
Specialties
- Occupational Therapist - Gerontology
Languages spoken
- English
Location
First Address
- Ms. Beverly Louise Stephens
- 3020 N Victoria Ave
- Peoria, IL
- Zip : 61604-2322
- Phone : (309) 657-8704
Second Address
- Ms. Beverly Louise Stephens
- 3020 N Victoria Ave
- Peoria, IL
- Zip : 61604-2322
- Phone : (309) 657-8704
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XG0600X | Occupational Therapist - Gerontology | 057'002773 | IL |
National Provider Identifier
| NPI | 1104298645 |
|---|---|
| Provider Name | Ms. Beverly Louise Stephens |
| First Address | Peoria, IL 61604-2322 |
| Second Address | Peoria, IL 61604-2322 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/10/2015 |
| Last Update Date | 23/10/2015 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.