Doctor Name: | MRS. STEPHANIE LYNN PRESTWICH |
NPI Number: | 1023203809 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED. |
License Number: | 3382048 |
Business Practice Address: | 500 W Old Linden Rd Show Low, AZ - 859014608 |
Business Phone Number: | 9285326850 |
Business Fax Number: | 9285376099 |
Mailing Address: | 501 W Stratton, SHOW LOW |
State: | AZ |
Postal Code: | 859016351 |
Phone Number: | 9285326850 |
Fax Number: | 9285376099 |
NPI Enumeration Date: | 09/13/2007 |
NPI Last Update Date: | 09/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YS0200X |
License Number: | 3382048 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | School |
Taxonomy Definition: |