Individual
LONNIE STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1103 IRONWOOD DRIVE, COEUR D ALENE, ID 83814
(208) 676-1003
Mailing address
1103 IRONWOOD DRIVE, COEUR D ALENE, ID 83814
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW-33081
ID
Other
Enumeration date
04/17/2014
Last updated
04/17/2014
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