1871193383 NPI number — CHRISTINE MALINA STEPHENSON RBT

Table of content: CHRISTINE MALINA STEPHENSON RBT (NPI 1871193383)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871193383 NPI number — CHRISTINE MALINA STEPHENSON RBT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEPHENSON
Provider First Name:
CHRISTINE
Provider Middle Name:
MALINA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RBT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROSS
Provider Other First Name:
CHRISTINE
Provider Other Middle Name:
MALINA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1871193383
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2405 PALMER CIR STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORMAN
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73069-6351
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-863-5539
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2405 PALMER CIR STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORMAN
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73069-6351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-323-6876
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/26/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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