Individual
MRS. BREANNA STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CBD
Contact information
Practice address
4063 COLUMBUS ST SE, ALBANY, OR 97322-6202
(541) 619-2333
Mailing address
4063 COLUMBUS ST SE, ALBANY, OR 97322-6202
(541) 619-2333
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
THW000003384
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
THW000003384
TRADITIONAL HEALTH WORKER
OR
Enumeration date
02/06/2019
Last updated
02/06/2019
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