Individual
KRYSTEENA JOY STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAMFT
Contact information
Practice address
410 S ORCHARD ST STE 128, BOISE, ID 83705-1288
(208) 817-0234
Mailing address
410 S ORCHARD ST STE 128, BOISE, ID 83705-1288
(208) 817-0234
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-7446
ID
106H00000X
Marriage & Family Therapist
LAMFT-6920
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC-7446
LICENSED PROFESSIONAL COUNSELOR NUMBER
ID
Enumeration date
05/25/2018
Last updated
12/14/2019
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