Provider Demographics
NPI:1811028905
Name:STEVENSON, SABRINA (BS)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 NW 137TH ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1952
Mailing Address - Country:US
Mailing Address - Phone:918-360-5105
Mailing Address - Fax:
Practice Address - Street 1:813 NW 137TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-1952
Practice Address - Country:US
Practice Address - Phone:918-360-5105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health