Individual
KATRINA L DOROW STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
230 PARK ST, WAUTOMA, WI 54982-9031
(920) 787-6550
(920) 787-0421
Mailing address
PO BOX 1230, WAUTOMA, WI 54982-1230
(920) 787-6550
(920) 787-0421
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2786
WI
101YP2500X
Professional Counselor
Primary
6827
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100067177
—
WI
Enumeration date
05/26/2017
Last updated
03/05/2018
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