Individual
DR. CHARLES STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1127 S PATRICK DR, SUITE 24, SATELLITE BEACH, FL 32937-3939
(321) 773-1111
(321) 773-1692
Mailing address
2917 MONDAVI DR, ROCKLEDGE, FL 32955-5188
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PY4176
FL
Other
Enumeration date
01/15/2007
Last updated
07/08/2007
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