Individual
STEPHANIE S STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, OT/L
Contact information
Practice address
1801 S 4J RD, GILLETTE, WY 82718-5201
(307) 682-2392
Mailing address
1801 S 4J RD, GILLETTE, WY 82718-5201
(307) 682-2392
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT-1353
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51402343
—
CO
Enumeration date
01/16/2008
Last updated
05/01/2025
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