Individual
JESSICA STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, BCBA
Contact information
Practice address
623 SUNDANCE DR, BALDWYN, MS 38824-6026
(662) 598-5903
Mailing address
5327 WYNTREE CV, TUPELO, MS 38801-8998
(662) 598-5903
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/05/2015
Last updated
03/23/2020
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