| Jack Stephens, | |
|
801 Old Harshman Rd, Riverside, OH 45431-1238 | |
| (937) 259-6603 | |
| (937) 259-6611 |
| Full Name | Jack Stephens |
|---|---|
| Gender | Male |
| Speciality | Psychologist - School |
| Location | 801 Old Harshman Rd, Riverside, Ohio |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700200680 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TS0200X | Psychologist - School | 1155279 (Ohio) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jack Stephens, 801 Old Harshman Rd, Riverside, OH 45431-1238 Ph: () - | Jack Stephens, 801 Old Harshman Rd, Riverside, OH 45431-1238 Ph: (937) 259-6603 |
Sherri Mackenzie, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 801 Old Harshman Rd, Riverside, OH 45431 Phone: 937-259-6603 Fax: 937-259-6611 | |
Mr. David Profitt, ED. S. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 801 Old Harshman Rd, Riverside, OH 45431 Phone: 937-259-6603 |