Provider Demographics
NPI:1700045499
Name:SAUNDERS, STEPHENIE JAMES
Entity Type:Individual
Prefix:
First Name:STEPHENIE
Middle Name:JAMES
Last Name:SAUNDERS
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:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:AK
Mailing Address - Zip Code:99574-0160
Mailing Address - Country:US
Mailing Address - Phone:907-424-8300
Mailing Address - Fax:907-424-8645
Practice Address - Street 1:602 CHASE AVE
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:AK
Practice Address - Zip Code:99574-0160
Practice Address - Country:US
Practice Address - Phone:907-424-8300
Practice Address - Fax:907-424-8645
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK84101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional