Provider Demographics
NPI:1801036181
Name:STEVENS, DENISE ANNE (MSCCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:ANNE
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 HUNTERS HILL DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19543-8837
Mailing Address - Country:US
Mailing Address - Phone:484-364-1947
Mailing Address - Fax:
Practice Address - Street 1:28 HUNTERS HILL DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:PA
Practice Address - Zip Code:19543-8837
Practice Address - Country:US
Practice Address - Phone:484-364-1947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL006737L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist