Individual
BENITA STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2607 WELSH RD APT F306, PHILADELPHIA, PA 19114-3320
(215) 432-6088
Mailing address
2607 WELSH RD APT F306, PHILADELPHIA, PA 19114-3320
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OC006859L
PA
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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