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1417459132
STEPHEN DALE FANNIN
PORTSMOUTH, VA
NPI
1417459132
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TS0200X Psychologist, School
Enumeration Date
2018-03-08
Last Update Date
2018-03-08
Business Address
STEPHEN DALE FANNIN Ed.S.
2801 TURNPIKE RD
PORTSMOUTH, VA 23707-4630
Phone number: 757-393-8766
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Mailing Address
STEPHEN DALE FANNIN Ed.S.
325 COLONY RD
NEWPORT NEWS, VA 23602-6342
Phone number: 757-877-3132
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