Doctor Name: | KEILAH STEVENS |
NPI Number: | 1386044618 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ED.S. |
License Number: | 3089284 |
Business Practice Address: | 107 Lancaster Dr Heath, OH - 430561220 |
Business Phone Number: | 7407883218 |
Business Fax Number: | |
Mailing Address: | 3048 Bremen St, COLUMBUS |
State: | OH |
Postal Code: | 432244366 |
Phone Number: | 7404127169 |
Fax Number: | |
NPI Enumeration Date: | 08/22/2014 |
NPI Last Update Date: | 08/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 3089284 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |