Individual
STEPHENIE D DEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
225 CROSSLAKE DR, EVANSVILLE, IN 47715-8198
(812) 471-6677
Mailing address
7300 E INDIANA ST, SUITE 102, EVANSVILLE, IN 47715-2794
(812) 476-0409
(812) 476-1016
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31004820A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000627945
BLUE CROSS BLUE SHIELD
IN
05
—
200966180
—
IN
Enumeration date
08/12/2009
Last updated
02/03/2010
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