Provider Demographics
NPI:1518245562
Name:STANKUS, STEFANIE
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:STANKUS
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 1:3291 MINNOW CREEK DR
Mailing Address - Street 2:
Mailing Address - City:HERNANDO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34607-2846
Mailing Address - Country:US
Mailing Address - Phone:352-585-4044
Mailing Address - Fax:352-694-7581
Practice Address - Street 1:9 DAHLIA CT N
Practice Address - Street 2:
Practice Address - City:HOMOSASSA
Practice Address - State:FL
Practice Address - Zip Code:34446-5531
Practice Address - Country:US
Practice Address - Phone:888-809-3583
Practice Address - Fax:888-809-3583
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst