Provider Demographics
NPI:1790232452
Name:RANCOURT, STEPHANIE
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:RANCOURT
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 1:160 SPRING WIND WAY
Mailing Address - Street 2:
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-5126
Mailing Address - Country:US
Mailing Address - Phone:407-748-7387
Mailing Address - Fax:407-949-6137
Practice Address - Street 1:160 SPRING WIND WAY
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-5126
Practice Address - Country:US
Practice Address - Phone:407-748-7387
Practice Address - Fax:407-949-6137
Is Sole Proprietor?:No
Enumeration Date:2016-09-09
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor