Individual
CONNIE STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6302 E DEER FARM RD, WILLIAMS, AZ 86046-8402
(928) 607-9099
Mailing address
6302 E DEER FARM RD, WILLIAMS, AZ 86046-8402
(928) 607-9099
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
6324240
AZ
Other
Enumeration date
11/25/2014
Last updated
11/25/2014
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