Individual
LISA MICHELLE STEPHANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAPC
Contact information
Practice address
12586 NORTH MAIN STREET, TRENTON, GA 30752
(706) 956-5526
(706) 639-2054
Mailing address
501 MIZE ST, LA FAYETTE, GA 30728-3346
(706) 638-5580
(706) 639-2054
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC005882
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00604513-GA
—
GA
Enumeration date
06/15/2017
Last updated
03/17/2018
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