Provider Demographics
NPI:1336491208
Name:PIMENTAL, STEPHANIE ANN
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:ANN
Last Name:PIMENTAL
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 1:952 S MAIN ST
Mailing Address - Street 2:APT. 2S
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02724-2816
Mailing Address - Country:US
Mailing Address - Phone:401-935-9975
Mailing Address - Fax:
Practice Address - Street 1:952 S MAIN ST
Practice Address - Street 2:APT. 2S
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02724-2816
Practice Address - Country:US
Practice Address - Phone:401-935-9975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor