Individual
LISA H. STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
405 S THORNTON AVE, DALTON, GA 30720-8285
(706) 226-1146
Mailing address
2310 COLEY FARM RD, ROCKY FACE, GA 30740-9734
(706) 673-6151
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
040248
GA
2084P0804X
Child & Adolescent Psychiatry Physician
040248
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00665871D
—
GA
Enumeration date
06/27/2006
Last updated
07/28/2014
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