Individual
CHARLES STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4308 S GRAND ST, MONROE, LA 71202-6322
(318) 282-2619
Mailing address
644 E JEFFERSON AVE, BASTROP, LA 71220-4619
(318) 239-3862
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/06/2017
Last updated
09/14/2022
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