Provider Demographics
NPI:1932572187
Name:STEPHENSON, KITTREDGE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KITTREDGE
Middle Name:
Last Name:STEPHENSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 N POST OAK RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-3842
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:730 N POST OAK RD
Practice Address - Street 2:SUITE 301
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-3842
Practice Address - Country:US
Practice Address - Phone:713-364-3728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37068103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist