Individual
MR. DURANT VILISIO STEPHENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
3732 VETERAN AVE APT 206, LOS ANGELES, CA 90034-7058
(917) 312-5188
Mailing address
3732 VETERAN AVE APT 206, LOS ANGELES, CA 90034-7058
(917) 312-5188
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
18819
CA
Other
Enumeration date
01/25/2021
Last updated
01/25/2021
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