Provider Demographics
NPI:1417200262
Name:STEPHANIE A STOWMAN, PHD
Entity type:Organization
Organization Name:STEPHANIE A STOWMAN, PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:STOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:702-279-3294
Mailing Address - Street 1:11176 MONTAGNE MARRON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-3870
Mailing Address - Country:US
Mailing Address - Phone:702-690-5943
Mailing Address - Fax:
Practice Address - Street 1:4055 SPENCER ST
Practice Address - Street 2:SUITE 126
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-9303
Practice Address - Country:US
Practice Address - Phone:702-690-5943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-17
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0623103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty