Provider Demographics
NPI:1174957542
Name:CANTON, STEPHANIE (MS)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:CANTON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10813 SW 34TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-3501
Mailing Address - Country:US
Mailing Address - Phone:305-213-2406
Mailing Address - Fax:
Practice Address - Street 1:10813 SW 34TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-3501
Practice Address - Country:US
Practice Address - Phone:305-213-2406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health