Individual
MR. CODY DON STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 N FISHER ST APT 9, TISHOMINGO, OK 73460-1318
(580) 920-5745
Mailing address
501 N FISHER ST APT 9, TISHOMINGO, OK 73460-1318
(580) 920-5745
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/01/2013
Last updated
05/01/2013
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