Provider Demographics
NPI:1811537160
Name:GEORGE, STEPHANIE
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:FRANCISCA
Other - Last Name:CHARLES-NICHOLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:581 N PARK AVE UNIT 2791
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32704-8720
Mailing Address - Country:US
Mailing Address - Phone:240-277-8688
Mailing Address - Fax:407-814-8767
Practice Address - Street 1:507 LANCER OAK DR
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-2762
Practice Address - Country:US
Practice Address - Phone:407-814-8767
Practice Address - Fax:407-814-8767
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker