Doctor Name: | MRS. LISA MAE STEPHENS |
NPI Number: | 1699912071 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ASW |
License Number: | 15930 |
Business Practice Address: | 2731 Nugget Avenue Lake Isabella, CA - 93240 |
Business Phone Number: | 7603793412 |
Business Fax Number: | |
Mailing Address: | Po Box 2131, LAKE ISABELLA |
State: | CA |
Postal Code: | 932402131 |
Phone Number: | 7603784180 |
Fax Number: | |
NPI Enumeration Date: | 01/07/2009 |
NPI Last Update Date: | 01/07/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 15930 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |