Provider Demographics
NPI:1629656673
Name:STEVENSON, BETHANIE ANNE (MFT)
Entity Type:Individual
Prefix:
First Name:BETHANIE
Middle Name:ANNE
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 BELL ROCK PLAZA
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86351-9040
Mailing Address - Country:US
Mailing Address - Phone:928-284-2690
Mailing Address - Fax:
Practice Address - Street 1:90 BELL ROCK PLZ
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86351-9040
Practice Address - Country:US
Practice Address - Phone:928-284-2690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist