Individual
JOHN STEVENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
TSE, TSHH
Contact information
Practice address
42 LAKE AVENUE EXT, 286, DANBURY, CT 06811-5279
(516) 769-5274
(516) 706-1962
Mailing address
42 LAKE AVENUE EXT, 286, DANBURY, CT 06811-5279
(516) 769-5274
(516) 706-1962
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
20193329
NY
Other
Enumeration date
02/23/2011
Last updated
02/23/2011
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