Individual
DORRIAN INEZ STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 E LINCOLN HWY, NEW LENOX, IL 60451-1992
(779) 707-3717
Mailing address
3012 BONNIE BRAE CRES, FLOSSMOOR, IL 60422-2028
(708) 717-7677
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.006047
IL
Other
Enumeration date
01/19/2024
Last updated
01/19/2024
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