Provider Demographics
NPI:1841718004
Name:SAVAGE, STEFANI BETH
Entity type:Individual
Prefix:
First Name:STEFANI
Middle Name:BETH
Last Name:SAVAGE
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 1:3520 CLEVELAND HEIGHTS BLVD APT 133
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-4877
Mailing Address - Country:US
Mailing Address - Phone:863-409-9261
Mailing Address - Fax:
Practice Address - Street 1:3520 CLEVELAND HEIGHTS BLVD APT 133
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4877
Practice Address - Country:US
Practice Address - Phone:863-409-9261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2017-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator