Provider Demographics
NPI:1346428471
Name:STEVENS, MARY ELIZABETH (PT)
Entity Type:Individual
Prefix:MISS
First Name:MARY
Middle Name:ELIZABETH
Last Name:STEVENS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 TRAIL TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-2305
Mailing Address - Country:US
Mailing Address - Phone:239-649-2222
Mailing Address - Fax:239-649-0522
Practice Address - Street 1:999 TRAIL TERRACE DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-2305
Practice Address - Country:US
Practice Address - Phone:239-649-2222
Practice Address - Fax:239-649-0522
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21237225100000X
CAPT18228225100000X
TX1094035225100000X
MT853PT225100000X
CT007362225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist