Individual
ALISIA DAWN STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4820 BANDANA ROAD, BANDANA, KY 42022
(270) 224-2065
Mailing address
PO BOX 33, 4820 BANDANA ROAD, BANDANA, KY 42022-0033
(270) 224-2065
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
133572
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133572
KENTUCKY STATE LICENSE
KY
Enumeration date
03/20/2007
Last updated
08/26/2019
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