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1013013010
MICHAEL L STEVENS
POCATELLO, ID
NPI
1013013010
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: ID LCSW-1279)
Enumeration Date
2006-09-16
Last Update Date
2021-12-10
Business Address
MICHAEL L STEVENS LCSW
109 N ARTHUR AVE STE 203
POCATELLO, ID 83204-3105
Phone number: 208-234-4673
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Mailing Address
MICHAEL L STEVENS LCSW
109 N ARTHUR AVE STE 203
POCATELLO, ID 83204-3105
Phone number: 208-234-4673
Copy
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