Individual
MARK D. STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
1409 CLEVELAND AVE, MARINETTE, WI 54143-3918
(920) 496-4700
Mailing address
PO BOX 19070, GREEN BAY, WI 54307-9070
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15369-131
WI
Other
Enumeration date
08/01/2007
Last updated
02/16/2021
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