Individual
MISTY DAWN STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
163 OLD HUNTSVILLE RD, FAYETTEVILLE, TN 37334-6015
(931) 993-7081
Mailing address
163 OLD HUNTSVILLE RD, FAYETTEVILLE, TN 37334-6015
(931) 993-7081
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4564C
AL
Other
Enumeration date
12/18/2020
Last updated
12/18/2020
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