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Individual

MRS. STEPHANIE RENEE DATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
285 HINDMAN LN, TALLADEGA, AL 35160-6448
(256) 493-2282
Mailing address
285 HINDMAN LN, TALLADEGA, AL 35160-6448
(256) 493-2282

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4876C
AL

Other

Enumeration date
06/10/2022
Last updated
06/10/2022
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