Individual
STEPHANIE NEWSOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,LMHC, NCC
Contact information
Practice address
118 1ST ST SW, WAVERLY, IA 50677-3321
(319) 230-6668
Mailing address
503 CATALINA AVE, WAVERLY, IA 50677-3940
(319) 230-6668
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
00781
IA
Other
Enumeration date
09/23/2016
Last updated
03/08/2017
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