Provider Demographics
NPI:1720683139
Name:STIVENSON, BARBARA J (RBT)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:J
Last Name:STIVENSON
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MISS
Other - First Name:BARBARA
Other - Middle Name:J
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 FRANKLIN DR
Mailing Address - Street 2:
Mailing Address - City:PENNELLVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13132-3125
Mailing Address - Country:US
Mailing Address - Phone:315-806-1737
Mailing Address - Fax:
Practice Address - Street 1:5 FRANKLIN DR
Practice Address - Street 2:
Practice Address - City:PENNELLVILLE
Practice Address - State:NY
Practice Address - Zip Code:13132-3125
Practice Address - Country:US
Practice Address - Phone:315-806-1737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health