Doctor Name: | BARBARA STEPHEN |
NPI Number: | 1558769695 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 199 Mcnabb Shortcut Road Loris, SC - 295697202 |
Business Phone Number: | 8437561403 |
Business Fax Number: | 8437564792 |
Mailing Address: | 199 Mcnabb Shortcut Rd, LORIS |
State: | SC |
Postal Code: | 295697201 |
Phone Number: | 8437561403 |
Fax Number: | 8437564792 |
NPI Enumeration Date: | 12/05/2014 |
NPI Last Update Date: | 12/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP1600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Pastoral |
Taxonomy Definition: |