Provider Demographics
NPI:1366845521
Name:STEVENSON, ANN
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:
Last Name:STEVENSON
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 1:2283 N SAINT JAMES PKWY
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-3657
Mailing Address - Country:US
Mailing Address - Phone:216-321-2414
Mailing Address - Fax:
Practice Address - Street 1:1111 SUPERIOR AVE E STE 1800
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-2500
Practice Address - Country:US
Practice Address - Phone:216-838-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool