| NPI | 1154159523 |
|---|---|
| Former Legal Business Name | STEPHANIE VICE PSYCHOLOGICAL SERVICES & CONSULTING |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE BONO President 618-900-7909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2024-07-25 |
| Last Update Date | 2025-09-02 |