Provider Demographics
NPI:1053529610
Name:STEVENS, MAUREEN (PT)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 CAHABA VALLEY PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-2217
Mailing Address - Country:US
Mailing Address - Phone:205-314-7227
Mailing Address - Fax:205-314-7222
Practice Address - Street 1:245 CAHABA VALLEY PKWY STE 200
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-2217
Practice Address - Country:US
Practice Address - Phone:205-314-7227
Practice Address - Fax:205-314-7222
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2012-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH 3054174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist