Provider Demographics
NPI:1295096766
Name:PIERCE, STEPHANIE LYNNE
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:LYNNE
Last Name:PIERCE
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 1:4621 HERITAGE PLACE DR
Mailing Address - Street 2:APT# 2007
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-4388
Mailing Address - Country:US
Mailing Address - Phone:405-618-3469
Mailing Address - Fax:
Practice Address - Street 1:4621 HERITAGE PLACE DR
Practice Address - Street 2:APT# 2007
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-4388
Practice Address - Country:US
Practice Address - Phone:405-618-3469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health