Provider Demographics
NPI:1518685593
Name:STEPHENS, VICTORIA MELAINA
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MELAINA
Last Name:STEPHENS
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 1:1016 BLUEBIRD WAY
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-1619
Mailing Address - Country:US
Mailing Address - Phone:940-882-1562
Mailing Address - Fax:
Practice Address - Street 1:10931 STONE HOUSE LN
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-8055
Practice Address - Country:US
Practice Address - Phone:214-494-0727
Practice Address - Fax:214-551-1411
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst