Provider Demographics
NPI:1891459970
Name:ALTENBERNT, STEVEE K
Entity type:Individual
Prefix:
First Name:STEVEE
Middle Name:K
Last Name:ALTENBERNT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3410 SUMAC CT APT 102
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-1242
Mailing Address - Country:US
Mailing Address - Phone:517-243-5073
Mailing Address - Fax:
Practice Address - Street 1:3410 SUMAC CT APT 102
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-1242
Practice Address - Country:US
Practice Address - Phone:517-243-5073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician