Provider Demographics
NPI:1467718973
Name:STEGNER, KATHERINE (DT-H)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:STEGNER
Suffix:
Gender:F
Credentials:DT-H
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 GLENDALE DR
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-4450
Mailing Address - Country:US
Mailing Address - Phone:217-224-6475
Mailing Address - Fax:
Practice Address - Street 1:239 GLENDALE DR
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-4450
Practice Address - Country:US
Practice Address - Phone:217-224-6475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist