Provider Demographics
NPI:1518240415
Name:STEPHENS, DAWN NICOLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:NICOLE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 403 BOX 4536
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09059-0046
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:DR HITZELBERGER STRASSE
Practice Address - Street 2:
Practice Address - City:LANDSTUHL
Practice Address - State:RHEINLAND PFALZ
Practice Address - Zip Code:66849
Practice Address - Country:DE
Practice Address - Phone:49151-298-5129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1772103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling