Provider Demographics
NPI:1619243318
Name:STATHOPOULOU, STEPHANY (BS)
Entity Type:Individual
Prefix:
First Name:STEPHANY
Middle Name:
Last Name:STATHOPOULOU
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7715 NW 48TH ST
Mailing Address - Street 2:SUITE 360
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-5455
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7715 NW 48TH ST
Practice Address - Street 2:APT. 1754
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-5455
Practice Address - Country:US
Practice Address - Phone:617-955-1151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst