Provider Demographics
NPI:1982397162
Name:STEVENS, RHIANNON ALISSA (QMHS)
Entity Type:Individual
Prefix:
First Name:RHIANNON
Middle Name:ALISSA
Last Name:STEVENS
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5726 SOUTHWYCK BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-1510
Mailing Address - Country:US
Mailing Address - Phone:419-708-0441
Mailing Address - Fax:
Practice Address - Street 1:122 W 2ND ST STE 100
Practice Address - Street 2:
Practice Address - City:PORT CLINTON
Practice Address - State:OH
Practice Address - Zip Code:43452-1013
Practice Address - Country:US
Practice Address - Phone:419-708-0441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator