Individual
MR. TODD STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2609 S 10TH AVE STE 102, CALDWELL, ID 83605-6885
(208) 454-2766
Mailing address
1432 N ANTIMONY PL, KUNA, ID 83634-3390
(208) 602-9120
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-33649
ID
Other
Enumeration date
12/23/2014
Last updated
12/23/2014
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