| Doctor Name: | PHYLLIS STEVENS |
| NPI Number: | 1235537960 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. |
| License Number: | BG1005512 |
| Business Practice Address: | 525 E Main St Hebron, OH - 430259702 |
| Business Phone Number: | 7409285878 |
| Business Fax Number: | |
| Mailing Address: | 525 E Main St, HEBRON |
| State: | OH |
| Postal Code: | 430259702 |
| Phone Number: | 7409285878 |
| Fax Number: | |
| NPI Enumeration Date: | 12/11/2014 |
| NPI Last Update Date: | 12/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | BG1005512 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |