Provider Demographics
NPI:1891282711
Name:STEPHENS, AQUILA DENISE (MA)
Entity type:Individual
Prefix:
First Name:AQUILA
Middle Name:DENISE
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 E FOUNTAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3502
Mailing Address - Country:US
Mailing Address - Phone:719-728-2465
Mailing Address - Fax:719-545-4337
Practice Address - Street 1:1440 E FOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3502
Practice Address - Country:US
Practice Address - Phone:719-728-2465
Practice Address - Fax:719-545-4337
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional