Individual
AMANDA D STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
505 BREVARD AVE, COCOA, FL 32922-7973
(321) 632-5792
Mailing address
505 BREVARD AVE, COCOA, FL 32922-7973
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
12561
FL
101YM0800X
Mental Health Counselor
Primary
16392
FL
Other
Enumeration date
02/01/2017
Last updated
10/17/2018
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