Provider Demographics
NPI:1659845048
Name:ABELLAN, STEPHANIE GISELLE
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:GISELLE
Last Name:ABELLAN
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 1:25 SE 2ND AVE STE 1144
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-1605
Mailing Address - Country:US
Mailing Address - Phone:305-204-8757
Mailing Address - Fax:888-414-2017
Practice Address - Street 1:25 SE 2ND AVE STE 1144
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-1605
Practice Address - Country:US
Practice Address - Phone:305-610-2712
Practice Address - Fax:888-414-2017
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-18
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst