Provider Demographics
NPI:1629146394
Name:KENT, STEPHANIE LYNN (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LYNN
Last Name:KENT
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:LYNN
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OCCUPATIONAL THERAPI
Mailing Address - Street 1:2200 HAVASUPAI BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403
Mailing Address - Country:US
Mailing Address - Phone:928-505-6911
Mailing Address - Fax:928-505-6991
Practice Address - Street 1:2200 HAVASUPAI BOULEVARD
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403
Practice Address - Country:US
Practice Address - Phone:928-505-6911
Practice Address - Fax:928-505-6991
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist