Provider Demographics
NPI:1619298650
Name:STILTNER, STEPHANIE
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:STILTNER
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 1:122 PINE ST
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-9122
Mailing Address - Country:US
Mailing Address - Phone:606-454-3689
Mailing Address - Fax:606-454-3689
Practice Address - Street 1:122 PINE ST
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-9122
Practice Address - Country:US
Practice Address - Phone:606-454-3689
Practice Address - Fax:606-454-3689
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health