Provider Demographics
NPI:1184636862
Name:HOYT, STEPHANIE WILLIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:WILLIS
Last Name:HOYT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 OXFORD RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-4742
Mailing Address - Country:US
Mailing Address - Phone:252-436-2617
Mailing Address - Fax:
Practice Address - Street 1:2625 OXFORD RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-4742
Practice Address - Country:US
Practice Address - Phone:252-436-2617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2590103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical