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Individual
MR. MARK WAYNE STEVENS
Active
Individual
MR. MARK WAYNE STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC, CSAC II
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0794
MO
106H00000X
Marriage & Family Therapist
Primary
2006012732
MO
Other
Enumeration date
06/08/2008
Last updated
06/08/2008
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