Individual
TARA MARIE STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., LADC UNDER SU
Contact information
Practice address
309 W MAIN ST, WILBURTON, OK 74578-4047
(918) 465-3381
(918) 465-3053
Mailing address
309 W MAIN ST, WILBURTON, OK 74578-4047
(918) 465-3381
(918) 465-3053
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/03/2010
Last updated
09/23/2011
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