Willis, Stephanie

Willis, Stephanie is an individual health care provider with primary practice located at 684 Grayson Pkwy , Grayson GA 30017-1211. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Pastoral, Student, Health Care / Student in an Organized Health Care Education/Training Program, Other Service Providers / Health Educator. Other Service Providers / Health Educator is her primary health care specialty. Willis, Stephanie can be contacted via phone (678) 353-6658.

Contact Information

Primary practice address
684 Grayson Pkwy Grayson GA 30017-1211
Phone: (678) 353-6658
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Pastoral 101YP1600X 744042 Georgia
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Other Service Providers / Health Educator 174H00000X

Profile Details

NPI number 1871240002
LBN Legal business name Willis, Stephanie
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2022
Last updated Mar 8th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871240002 NPPES
Georgia Other NONE NONE

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