Individual
CRAIG D STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD LP
Contact information
Practice address
624 S 13TH ST, RANGE MENTAL HEALTH CENTER INC, VIRGINIA, MN 55792
(218) 749-2881
(218) 749-3806
Mailing address
624 S 13TH ST, RANGE MENTAL HEALTH CENTER INC, VIRGINIA, MN 55792
(218) 749-2881
(218) 749-3806
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP0664
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108747900
—
MN
Enumeration date
09/26/2006
Last updated
09/23/2010
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