Individual
KIM STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH BS MBA OM
Contact information
Practice address
3921 S 24TH ST, QUINCY, IL 62305-8925
(573) 231-6385
Mailing address
3921 S 24TH ST, QUINCY, IL 62305-8925
(573) 231-6385
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
001181
MO
Other
Enumeration date
02/11/2014
Last updated
02/11/2014
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