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Individual

MRS. JUDITH RENEE STEVENSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LPC-T

Contact information

Practice address
631 FOREST ST, WAUSAU, WI 54403-5524
(715) 842-0944
(715) 845-6477
Mailing address
631 FOREST ST, WAUSAU, WI 54403-5524
(715) 842-0944
(715) 845-6477

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5258-226
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5258-226
STATE LICENSE #
WI
Enumeration date
03/14/2022
Last updated
03/14/2022
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