Individual
KIM E STEPHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
509 3RD AVE SE, PINE CITY, MN 55063-1508
(651) 491-6508
(320) 629-9983
Mailing address
645 3RD AVE SW, PINE CITY, MN 55063-1443
(320) 629-0059
(320) 629-9983
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
305303
MN
Other
Enumeration date
10/12/2023
Last updated
10/12/2023
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