Individual
MR. GEORGE HARRY STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., CCC-SLP
Contact information
Practice address
5681 NEBESHONE LN, ROCKFORD, IL 61103-8917
(815) 877-2615
(815) 877-2615
Mailing address
5681 NEBESHONE LN, ROCKFORD, IL 61103-8917
(815) 877-2615
(815) 877-2615
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146000897
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146000897
STATE OF ILLINOIS
IL
Enumeration date
01/25/2008
Last updated
01/25/2008
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