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1992253165
MARK STEVENS
LEWISTON, ID
NPI
1992253165
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: ID LPC677)
Enumeration Date
2016-09-16
Last Update Date
2016-09-16
Business Address
-- MARK STEVENS
312 MILLER ST
LEWISTON, ID 83501-1944
Phone number: 208-750-1802
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Mailing Address
-- MARK STEVENS
2513 9TH AVE
LEWISTON, ID 83501-3459
Phone number: 208-816-0721
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