Provider Demographics
NPI:1497137954
Name:BRUCE, STEPHANIE L
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:L
Last Name:BRUCE
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 1:55A WOODY ACRES DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:AL
Mailing Address - Zip Code:36874-3213
Mailing Address - Country:US
Mailing Address - Phone:334-614-2406
Mailing Address - Fax:
Practice Address - Street 1:55A WOODY ACRES DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:AL
Practice Address - Zip Code:36874-3213
Practice Address - Country:US
Practice Address - Phone:334-614-2406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health