Provider Demographics
NPI:1023551983
Name:SZALAI-STEPHENS, ILONA
Entity Type:Individual
Prefix:
First Name:ILONA
Middle Name:
Last Name:SZALAI-STEPHENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 E OLIVE RD # SETB
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-4820
Mailing Address - Country:US
Mailing Address - Phone:850-380-1865
Mailing Address - Fax:
Practice Address - Street 1:1300 E OLIVE RD STE B
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-4820
Practice Address - Country:US
Practice Address - Phone:850-380-1865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH13851101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health