Individual
BLAKE A. STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-4658
(319) 356-2587
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-4658
(319) 356-2587
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-14-16958
KS
1041C0700X
Clinical Social Worker
Primary
079022
IA
Other
Enumeration date
08/04/2015
Last updated
12/20/2021
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