Provider Demographics
NPI:1285190314
Name:STEPNEY, IMANI
Entity Type:Individual
Prefix:
First Name:IMANI
Middle Name:
Last Name:STEPNEY
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 1:189 EASTBROOK LN
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-2222
Mailing Address - Country:US
Mailing Address - Phone:609-556-7977
Mailing Address - Fax:
Practice Address - Street 1:498 BEVERLY RANCOCAS RD
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-3545
Practice Address - Country:US
Practice Address - Phone:856-452-1741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-13
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
NJ46TR00859600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist