Individual
MRS. KATIE SHEA STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
211 HIGHWAY 82 E, INDIANOLA, MS 38751-2234
(662) 887-3426
Mailing address
1111 MAIN ST, INDIANOLA, MS 38751-2934
(662) 931-3780
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3692-07DH
MS
Other
Enumeration date
08/08/2007
Last updated
08/08/2007
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