Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1033490412 |
---|---|
Provider Name | Stephynne Dawn Stevens |
First Address | Wynnewood, OK 73098-0203 |
Second Address | Tishomingo, OK 73460-1734 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2011 |
Last Update Date | 30/08/2011 |